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just what you paid in 2020 and don't include in this any amount paid through an HSA or FSA. i would also exclude any portion that you'll recover through insurance. if you deduct a medical expense in 2020 and get an insurance reimbursement in 2021 and assuming you used itemized deductions in 2020 the reimbursement would have to be included in income for 2021 not as an offset to medical expenses which could increase your tax bill.
"this year" Just the part you actually paid in 2020.
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