Even though you are under age 59½, you won’t be penalized for an IRA distribution used to pay medical expenses in excess of 7.5% of adjusted gross income in 2017 or 2018. The AGI threshold is set to rise to 10% in 2019. This penalty exception applies even if you claim the standard deduction. But the distribution must be taken in the same year that you incurred the medical expenses. And remember, the distribution is still includible in gross income.
Payments made to a separated or divorced spouse as required by a decree or agreement. Qualifying payments are deductible by the payor and taxable to the payee.