Expenses that are reimbursed from insurance are not also deductible (whether they are qualified or not) unless the payments from the insurance company are considered taxable income to you. This would be very rare.
The rule for deducting out-of-pocket (non-reimbursed medical expenses) is as follows:
Qualified deductible medical expenses are expenses for medical or nursing services. The services do not have to be provided by an actual nurse, but they must be of the type and kind of service that a nurse usually performs, which includes providing medication, assisting with eating, bathing, toileting, dressing, and so on. Companionship, room, board, laundry services, and so on, are not medical or nursing expenses. The LTC facility should be able to give you a breakdown of the expenses.
However, the entire expense of the LTC facility can be deducted as a medical expense if the patient meets all the following tests.
1. The patient is permanently disabled, which means that they have a condition which is permanent, or will last at least one year, or will lead to death, as certified by a doctor; or, the patient has a cognitive impairment and would be a danger to themself or others if left alone, also as certified by a doctor.
2. The patient requires assistance with two or more activities of daily living. Activities of daily living are eating, dressing, toileting, managing incontinence, transferring, and bathing.
3. The care is provided according to a written care plan that is developed by a qualified medical professional or medical social worker, and is reviewed and updated at least once a year.
If the patient is disabled or cognitively impaired and requires assistance with two or more ADLs but doesn't have a written care plan, you can only deduct the portion of the care that corresponds to actual nursing or medical care. If you get a written care plan, then expenses after the date the care plan is put in writing would be fully deductible medical expenses.
