Itemized deductions are specific personal expenses the tax code lets you subtract from your income before your federal tax is calculated, used in place of the flat standard deduction. The main categories are unreimbursed medical costs, state and local taxes, home mortgage interest, and charitable contributions, with a few narrower items like casualty losses in federally declared disasters and gambling losses. Itemizing only pays off when those expenses together exceed your standard deduction, which for the 2026 tax year is $32,200 for a married couple filing jointly, $16,100 for single filers and married filing separately, and $24,150 for heads of household.1Internal Revenue Service. IRS Releases Tax Inflation Adjustments for Tax Year 2026
The deduction reduces your taxable income, not your adjusted gross income. AGI is calculated first and controls eligibility for several credits and phase-outs, so itemizing changes the tax you owe without changing the income figure those other rules key off of.2Office of the Law Revision Counsel. 26 USC 63 – Taxable Income Defined If your qualifying expenses fall short of the standard deduction, take the standard amount and skip the paperwork. Most filers land there.
Medical and Dental Expenses
Unreimbursed medical and dental costs are deductible, but only the portion above 7.5% of your AGI. On $100,000 of AGI, the first $7,500 in spending doesn’t count; only dollars above that floor become part of the deduction.3Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses In practice this deduction matters most in years with a major health event.
Qualifying costs include payments to doctors, dentists, surgeons, and other medical practitioners; hospital stays; prescription drugs; and health insurance premiums paid with after-tax dollars. Equipment such as hearing aids, eyeglasses, and wheelchairs counts. So does travel for medical care, including mileage at the IRS rate of 20.5 cents per mile for 2026.4Internal Revenue Service. IRS Sets 2026 Business Standard Mileage Rate at 72.5 Cents Per Mile, Up 2.5 Cents Lodging tied to out-of-town treatment can qualify up to $50 per night per person.3Office of the Law Revision Counsel. 26 USC 213 – Medical, Dental, Etc., Expenses
Not every health-related expense qualifies. Cosmetic surgery is generally not deductible unless it corrects a deformity from a congenital condition, accident, or disease. Face lifts, hair transplants, and liposuction fail the test; breast reconstruction after a mastectomy qualifies.5Internal Revenue Service. Publication 502, Medical and Dental Expenses Vitamins and gym memberships also fall outside the definition because they support general health rather than treating a specific condition.
State and Local Taxes
You can deduct state and local property taxes plus either state and local income taxes or general sales taxes, but not both income and sales taxes in the same year. For 2026, the combined SALT deduction is capped at $40,400, or $20,200 for married filing separately.6Office of the Law Revision Counsel. 26 USC 164 – Taxes
Higher earners face a phasedown. If your modified adjusted gross income exceeds $505,000 (or $252,500 for married filing separately), the $40,400 cap shrinks by 30 cents for every dollar over the threshold. The cap cannot fall below $10,000.6Office of the Law Revision Counsel. 26 USC 164 – Taxes A single filer with MAGI of $605,000 in 2026, for example, would see the cap reduced by $30,000 (30% of the $100,000 above the threshold), leaving $10,400.
The income-or-sales-tax election is worth checking if you live in a state without an income tax. In that case, deducting sales taxes is your only option, and the IRS publishes tables and a calculator to estimate the amount if you didn’t save every receipt.
Home Mortgage Interest
Interest paid on a mortgage used to buy, build, or substantially improve your home is deductible on up to $750,000 of qualified debt, or $375,000 if you’re married filing separately.7Office of the Law Revision Counsel. 26 USC 163 – Interest The debt must be secured by a qualified residence, which can include your primary home and one second home. Loans that predate December 16, 2017, may still qualify under an older $1 million limit for the original balance.
Mortgage points can also be deducted. Points paid at closing to purchase your primary home are generally deductible in full in the year you pay them, provided the charge reflects an established local practice and you brought at least the amount of the points to closing in your own funds.8Internal Revenue Service. Topic No. 504, Home Mortgage Points Points paid on a refinance typically have to be spread over the life of the loan.
Your lender sends Form 1098 each January showing the mortgage interest you paid the prior year, and that form is the main documentation for the deduction.9Internal Revenue Service. Instructions for Form 1098
Charitable Contributions
Donations to qualifying tax-exempt organizations are deductible if you itemize. Cash contributions to public charities such as churches, schools, and hospitals are deductible up to 60% of your AGI for the year, and contributions over the limit carry forward for up to five additional years.10Office of the Law Revision Counsel. 26 USC 170 – Charitable, Etc., Contributions and Gifts
Non-cash donations like clothing, furniture, or vehicles follow different rules. If your total non-cash contributions exceed $500, you must file Form 8283 with your return.11Internal Revenue Service. Instructions for Form 8283 For any single item or group of similar items valued above $5,000, a qualified independent appraisal is required. Donated goods must be in good used condition or better.
Every cash gift needs a paper trail: a bank statement, canceled check, or written receipt from the organization showing name, date, and amount. For any single gift of $250 or more, you need a written acknowledgment from the recipient obtained before you file the return.10Office of the Law Revision Counsel. 26 USC 170 – Charitable, Etc., Contributions and Gifts Gifts to individuals, political organizations, and candidates do not qualify.
Casualty and Gambling Losses
Personal property losses from storms, fires, or theft are deductible only when the loss stems from a federally declared disaster. Everyday losses from fender benders, burst pipes, or stolen packages do not qualify.12Internal Revenue Service. Publication 547, Casualties, Disasters, and Thefts This restriction has been in place since 2018 and was extended past 2025 by recent legislation. A qualifying loss is further reduced by a $100-per-event floor and then by 10% of your AGI.
Gambling losses are deductible only up to the amount of gambling winnings you report as income for the same year. If you won $3,000 at a casino and lost $5,000 over the year, your deduction tops out at $3,000; you can’t use gambling losses to create an overall tax loss.13Internal Revenue Service. Topic No. 419, Gambling Income and Losses Keep a session-by-session log because the IRS expects substantiation.
Expenses That Do Not Qualify
Several costs that feel like they should be deductible are specifically excluded:
- Homeowners association fees for a personal residence are not deductible, even though they sit alongside property taxes on your housing bill.14Internal Revenue Service. Topic No. 503, Deductible Taxes
- Federal income tax itself is never deductible.
- Unreimbursed employee expenses for W-2 workers, including uniforms, professional dues, and home office costs, remain suspended and are not deductible for 2026.15Office of the Law Revision Counsel. 26 USC 67 – 2-Percent Floor on Miscellaneous Itemized Deductions
- Tax preparation fees, once deductible as a miscellaneous itemized expense, are also suspended through at least 2026.
- Political contributions to candidates, parties, or PACs are never deductible as charitable gifts.
When You Are Required to Itemize
Most people pick the method that saves more money, but one situation removes the choice. If you’re married and file separately and your spouse itemizes, you must itemize too. You cannot claim the standard deduction on your own return when your spouse is itemizing on theirs.16Internal Revenue Service. Other Deduction Questions This catches some couples off guard during separations, when the spouses may not be coordinating filing choices.
Filing Schedule A and Keeping Records
Schedule A (Form 1040) is where you list each category of itemized deductions and add them up. It’s available as a PDF on the IRS website and built into every major tax software package.17Internal Revenue Service. About Schedule A (Form 1040), Itemized Deductions The form runs through medical costs first (with the 7.5% AGI floor calculated on the form), then state and local taxes with the SALT cap, mortgage interest and points, charitable contributions in cash and non-cash, and a final line for other items like gambling losses. The completed Schedule A attaches to your Form 1040.
Keep records that support every line. Form 1098 covers mortgage interest. Medical expenses need receipts or explanation-of-benefits statements. Charitable contributions need bank records or written acknowledgments. Property tax payments can be verified through your county records or your mortgage escrow statement. The IRS generally requires you to keep supporting documents for at least three years from the date you filed the return, or two years from the date you paid the tax, whichever is later.18Internal Revenue Service. How Long Should I Keep Records? If the IRS spots a discrepancy, expect a notice asking for documentation on the specific items you claimed.