In home Care Giver services

[Old skier]

Where do you deduct In home Care Giver services? And how do you split (differentiate) deductible services?

[Vanessa A]

If you are paying an in home caregiver, you can claim them as a medical expense for you (the tax payer), your spouse or your dependent, if you are itemizing your return. 

You would allocate the deductible amount based on the time they spent with actual personal care services versus things like cleaning or transporting you to to the store.  

Things like giving meds, bathing, and dressing changes would be deductible. 

Itemized expenses include mortgage interest, gambling losses up to winnings,  charitable contributions, state and local taxes up to $10,000, medical expenses in excess of 7.5% of your AGI and casualty and losses in excess of 10% of you AGI with the first $100 not counting towards the loss.  Your health insurance and all medical expenses are only deductible for the amount that is over 7.5% of your AGI.  This means if your AGI is $50,000, then the amount that is over $3,750 is deductible.  

Then your total itemized expenses would need to be greater than your standard deduction below in order to benefit from your expenses. 

The 2024 Standard Deductions are as follows:

• Married Filing Joint (MFJ)              $29,200
• Married Filing Separate (MFS)      $14,600
• Head of Household (HOH)             $21,900 
• Single                                                 $14,600                                

Blind or over 65 and MFJ or MFS add $1,550

Single or HOH if blind or over 65 add $1,950

Standard versus Itemized Deduction

(edited 4/7/25 @ 11:28AMPST) @Old skier 

[Opus 17 · Accepted solution]

You can deduct medical expenses you pay for the care of yourself, your spouse, your dependents, or someone who qualifies to be your dependent except for the income or married filing jointly rule.  For example, you can deduct the cost of medical expenses for a parent if you pay more than half their total support, even if they are disqualified from being your tax dependent because they have more than $5050 of taxable income.  

You can deduct the cost of nursing services.  "The services need not be performed by a nurse as long as the services are of a kind generally performed by a nurse. This includes services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming the patient. These services can be provided in your home or another care facility."

You can't deduct the cost for companionship, meal prep, laundry, or other household services.  You must make a reasonable allocation as to how much time the caregiver spends providing nursing services.  If you hire a service, they may be able to give you a percentage, but if not, you have to figure it out.

You may be able to deduct the entire cost of long term care if the patient meets these two additional tests,

1. The individual is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence. OR the individual requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

2. The care is provided according to a written care plan prescribed by a qualified medical professional that is reviewed and re-certified at least once a year.

If the expenses are for a chronically ill person who meets the first test, but you don't have a written care plan, you can only deduct nursing services for now.  If you can get a written care plan, then your expenses after that point can be fully deductible.

If the person is unable to care for themselves due to a chronic illness as described above, and you have to pay for care so that you can work (and your spouse, if married), and they are your tax dependent, then you can also claim the Child and Dependent Care Credit.   But the person must be your tax dependent, this credit does not follow the looser rule for medical expenses.