Medical care expense deduction for long-term senior care services

Learn how this tax break can save you money on in-home senior care costs.

Medical care expense deduction for long-term senior care services

The national average hourly rate for home care currently ranges between $21.12 and $28.37, based on recent posted rates from in-home senior caregivers on Care.com. Over the course of the year, this adds up, but many families can offset a portion of this expense by taking the medical expense deduction when they file their tax return. In this article, we’ll go through:

Many people don’t think of in-home senior care as a medical expense because the perception is only hospitals and doctors’ offices handle medical needs. After all, the caregiver or companion being hired may not be administering medical treatment. As a result, families may not think to look for tax breaks on this expense or tell their accountant about it. However, the medical care expense deduction is the most common tax break available families with senior care needs can qualify for, and it should be taken into account for budgeting purposes.

What is the medical care expense deduction?

The medical expense deduction is an itemized deduction you can take on your personal income tax return. It covers a wide range of expenses, but for the sake of this article, we’re only going to focus on what you can deduct if you have long-term senior care needs. The full list of expenses are covered in IRS Publication 502 if you’re interested in doing a deeper dive on the topic. 

What types of long-term care services qualify for medical care expense deduction?

The IRS says diagnostic, preventive, therapeutic, curing, treating, mitigating, rehabilitative services and maintenance and personal care services can qualify. The person receiving care just has to have a licensed healthcare practitioner certify that they either need substantial supervision for their own safety or require help with at least two activities of daily living, such as eating, toileting, transferring, bathing and dressing. These requirements fit most in-home senior care scenarios because the person being hired to provide care will have to perform many of these duties. 

What expenses can I apply to the medical care expense deduction?

Expenses can only be applied if they fit the qualifications just mentioned. For many families with in-home senior care needs, they’ll include:

  • The wages paid to the caregiver any time they’re supervising the senior or helping them with activities of daily living.

  • The Social Security, Medicare, unemployment insurance and other employment taxes owed on those wages.

This is important to keep in mind because if the caregiver is only spending 80% of their time supervising the senior and helping them with activities of daily living, only 80% of what you pay them can be applied to the medical expense deduction. The remaining 20% of their time spent doing other household chores like laundry and dishes cannot be applied.

How much can I save by taking the medical care expense deduction?

This is dependent on what your Adjusted Gross Income (AGI) is and how much you’ll pay your caregiver. You can’t begin itemizing your in-home care expenses until they’re more than 7.5% of your AGI (10% if you are under 65 years old), so some people may save a little bit of money while others could save thousands. Because of this, you should speak to your accountant or CPA as they’ll have a much clearer picture of what your personal tax situation is.

Using the medical expense deduction is just part of several pieces that will make up your care budget. While HomePay can’t take care of this tax break for you, we’re happy to be the solution for the household employment tax and payroll needs you’ll have. Reach out to us today, and we’ll onboard your caregiver and make sure your IRS and state tax filing deadlines are always met.

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Tom Breedlove

Tom has been a member of the HomePay team for the last 15 years. He has worn many hats during his time with us, but currently works with thousands of staffing professionals, care managers, accountants, trustees, financial advisors and attorneys that have clients needing household employment support.

Co-author of The Household Employer’s Financial, Legal & HR Guide, Tom leads all education and outreach efforts on this complex topic. His work has helped HomePay become the featured expert on dozens of TV and radio shows, as well as countless business, consumer and trade publications. He also has conducted CPE lectures for more than a dozen professional organizations, including AICPA, NAEPC, AADMM, CPAacademy and Alliance of Comprehensive Planners.

Tom holds a BBA in finance with a minor in accounting from the University of Texas. Throughout his career, he’s been an active volunteer and speaker in the financial, marketing and care industries. If you’re ever at a conference where household employment is on the schedule, chances are, you’ll see Tom at the event.

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