Roughly one in five electronically filed tax returns that claim significant medical deductions are flagged for additional review by the IRS each year, according to estimates from tax professionals who follow agency processing data. Most filers never expect to be in that group — until they are.
I first connected with Travis Chen-Ramirez in early March 2026, after a financial counselor in Atlanta reached out to me saying she had a client whose story illustrated exactly how a delayed refund can unravel a carefully constructed financial plan. She didn’t oversell it. When I sat down with Travis at a coffee shop near his branch in Buckhead, he spread a manila folder of printed IRS notices across the table before he even ordered.
A Refund That Was Supposed to Be the Bridge
Travis Chen-Ramirez is 52, has worked as a bank teller for 19 years, and describes himself — with some dry humor — as “the guy who explains compound interest to customers while drowning in his own debt.” He and his wife of 23 years, Lorena, became empty nesters last fall when their youngest left for college. Lorena retired in August 2025 after 26 years in hospital administration, which is when the financial math got brutal.
When Lorena left her employer, the family lost their group health plan. They enrolled in COBRA continuation coverage in September 2025. The monthly premium: $2,340. Their mortgage on their home in the Decatur suburb of Atlanta runs $1,870 per month. Health insurance now cost more than their roof.
Three weeks after Lorena retired, she had a cardiac event. Travis described the call from the hospital — he was mid-transaction at his teller window — as the moment the financial floor fell out beneath him. The hospital stay, the cardiologist fees, the follow-up tests: the bills totaled roughly $28,000. Their insurance covered most of it, but only after a fight over out-of-network billing that took four months to resolve. The remaining $14,500 went onto a credit card at 21.9% APR.
By the time tax season arrived, Travis had run the numbers obsessively. He and Lorena had paid $28,080 in COBRA premiums in 2025 (12 months at $2,340). Combined with the unreimbursed medical costs, he believed they crossed the IRS threshold for deducting medical expenses — amounts exceeding 7.5% of adjusted gross income, as outlined in IRS Publication 502. His expected refund: $4,847.
Filing Early, Waiting Longer Than Expected
Travis filed his 2025 federal return electronically on February 12, 2026 — well before the April 15 deadline. The IRS acknowledged receipt on February 14. He used tax software and double-checked every Schedule A entry himself. “I kept re-running it,” he told me, “because I kept thinking I’d made an error and the number would drop.” It didn’t. The $4,847 held.
According to the IRS Where’s My Refund tool, most electronically filed returns with direct deposit are processed within 21 days. Travis watched the tool daily. On Day 8, the status bar moved from “Return Received” to “Return Being Processed.” Then it stopped moving.
Day 21 came and went. Day 28. On Day 34, a notice arrived in his mailbox.
The notice was a CP05. Travis recognized the form number immediately — he’d seen customers come into the bank branch with IRS correspondence they didn’t understand. “I knew what it was. That didn’t make it easier,” he said. The CP05 told him the IRS needed up to 60 additional days to review his return. No action required. Just wait.
What 60 Days Looks Like in Real Dollars
Travis had a plan for that $4,847. He intended to use it to pay down three months of COBRA premiums — buying time while he and Lorena researched Marketplace plans through HealthCare.gov during a special enrollment period. Without the refund arriving on schedule, those three months of premiums — $7,020 — had to come from somewhere else.
The COBRA premiums went onto the credit card — the same card already carrying $14,500 in medical debt at 21.9% APR. By the time I spoke with Travis in late March, he had added nearly $4,680 in new charges to that card. The refund, when it arrives, will essentially reimburse charges he was forced to make while waiting for it.
Navigating the IRS While Working Full-Time
Travis did eventually call the IRS — not because the CP05 instructed him to, but because the 60-day window had nearly elapsed and the “Where’s My Refund” tool still showed no update. He called the IRS Refund Hotline at 800-829-1954 on March 18, 2026. He waited on hold for two hours and nineteen minutes.
The agent he reached confirmed the return was under “standard income verification review” — a process that can be triggered when large medical deductions substantially reduce a taxpayer’s liability. The agent told Travis no additional documents were needed and that his refund had been approved internally. A direct deposit date of April 15, 2026 was provided verbally, though Travis noted the online tool still hadn’t updated as of our meeting.
Travis spent roughly three hours compiling documentation he was never asked to submit — receipts, Explanation of Benefits letters from the insurer, COBRA payment confirmations. “I’m a data person,” he told me. “When I don’t know what the problem is, I try to solve every possible version of it.” The documents sit in the manila folder he brought to our meeting, unused.
The Bigger Picture Travis Is Now Navigating
The $4,847 refund, even once it arrives, will not reset Travis’s financial position. His credit card balance will sit at roughly $19,180 — the original $14,500 in medical debt plus the COBRA charges added during the delay, plus two months of interest accrual. At 21.9% APR, he’s accumulating approximately $350 in interest charges monthly.
He and Lorena are now actively comparing Marketplace health plans for a May 1 start date, which would cut their monthly health insurance cost to an estimated $890 based on preliminary subsidy estimates tied to their projected 2026 household income. That shift, Travis said, would free up more than $1,400 per month — money that could actually move the needle on the credit card debt.
What struck me sitting across from Travis wasn’t frustration — it was the particular exhaustion of someone who had done everything right and still found themselves in a losing position. He filed on time. He documented every medical expense. He claimed a deduction he was legitimately entitled to. The IRS process worked exactly as designed. And the math still didn’t work out in his favor.
When I left the coffee shop, Travis was already back on his phone, re-checking the “Where’s My Refund” tool. The status still showed “Being Processed.” He’d set a reminder to check again the following morning. Some habits are hard to break.
Related: Someone Filed a Tax Return in His Name. The IRS Held His $3,200 Refund for 14 Months.
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