Home health care is deductible only if it qualifies as a medical expense

You can deduct home health care on your taxes, but only under specific conditions. The care must be primarily for medical reasons — not general household help or personal care that you could do yourself. The Internal Revenue Service (IRS) allows you to deduct unreimbursed medical expenses that exceed 7.5 percent of your adjusted gross income (AGI) on Schedule A, but home health care must meet their definition of a medical expense to count.

Home health care that qualifies includes skilled nursing, physical therapy, occupational therapy, and speech therapy provided by licensed professionals. It also includes care that helps someone who is ill, injured, or disabled perform activities of daily living — but only the portion of the cost that is truly medical in nature. If a home health aide is bathing and dressing an elderly parent who cannot do these things alone due to a medical condition, that cost may be deductible. If the same person is cooking meals and doing laundry for someone who is straightforward unable to do housework, that portion is not.

Key Takeaways

  • Home health care expenses are deductible only if they are primarily medical in nature and exceed 7.5 percent of your adjusted gross income.
  • Skilled nursing, physical therapy, and care for someone unable to perform daily activities due to illness or disability may may have access to, but general housekeeping does not.
  • You must itemize deductions on Schedule A to claim medical expenses; the standard deduction does not allow you to deduct them.
  • Keep receipts, invoices, and documentation from the health care provider showing the dates, services provided, and amounts paid.
  • If Medicare or insurance reimburses any portion of the cost, you can only deduct the amount you paid out of pocket.

What counts as a deductible medical expense

The IRS publishes a list of medical expenses in Publication 502. Home health care appears on that list, but with limits. The agency distinguishes between services that are medical in nature and services that are personal or household in nature. A nurse checking vital signs and administering medication counts. A home aide doing laundry does not — even if the person receiving care cannot do laundry themselves.

The line is often blurry. If a home health aide is helping someone bathe and dress because that person has arthritis or mobility problems from a medical condition, the cost is deductible. If the same aide is cooking meals, the meal preparation itself is not deductible, even though the person cannot cook. However, if the person is bedridden and the aide is preparing meals specifically as part of medical care (for example, preparing a prescribed diet for someone with kidney disease), you may be able to deduct that portion.

Costs for a live-in home health aide are deductible only for the time spent on medical care, not for time spent on general household tasks. If you pay someone $2,000 a month and they spend half their time on medical care and half on housekeeping, only $1,000 is deductible. You will need documentation from the provider showing how time was allocated.

The 7.5 percent threshold and itemizing deductions

Even if your home health care costs may have access to as medical expenses, you can only deduct the amount that exceeds 7.5 percent of your AGI. If your AGI is $60,000, you can deduct only the medical expenses above $4,500. This means that unless your medical costs are substantial, you may not benefit from deducting them at all.

You must also itemize deductions on Schedule A to claim medical expenses. If you take the standard deduction instead, you cannot deduct home health care costs. For the 2024 tax year, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly. Many people find that the standard deduction is larger than their itemized deductions, which means they cannot deduct medical expenses even if they have them.

Before you gather receipts, calculate whether itemizing makes sense for your situation. Add up all your deductible expenses — medical costs, state and local taxes (capped at $10,000), mortgage interest, charitable donations, and other itemizable expenses. If that total exceeds the standard deduction for your filing status, itemizing is worth pursuing.

Documentation you need to keep

The IRS requires documentation for any deduction you claim. For home health care, keep invoices and receipts from the provider showing the date, the services provided, the amount charged, and the amount you paid. If you paid out of pocket, keep proof of payment — a cancelled check, credit card statement, or bank transfer record.

If the provider is a licensed agency, their invoice should specify what services were rendered. If you hired an individual directly, ask them to provide a written statement of services for your records. If the care was for a dependent, keep documentation showing your relationship and that you paid more than half their support for the year.

If any portion of the cost was reimbursed by Medicare, Medicaid, insurance, or another source, you can only deduct the amount you paid yourself. Keep records of any reimbursements you received. The IRS may ask to see these documents if your return is audited, so store them for at least three years after you file.

When home health care is not deductible

General housekeeping, meal preparation, laundry, and transportation are not deductible, even if the person receiving care cannot do these things themselves. Costs for a companion or personal attendant who is not providing medical care do not may have access to. If you hire someone to help an elderly parent with daily tasks but there is no medical component, that expense is not deductible.

Costs for a nursing home, assisted living facility, or adult day care are generally not deductible as medical expenses, though there are narrow exceptions. If someone is in a facility primarily for medical care and the facility is licensed as a medical facility, a portion of the cost may be deductible. A standard assisted living facility where the person is living but receiving some medical services does not may have access to.

If you claim someone as a dependent and deduct their home health care costs, you cannot also claim them as a dependent if they have income above the threshold. The rules for dependent status are separate from the rules for medical deductions, so verify your situation before filing.

How to report home health care on your tax return

To deduct home health care costs, you must file Form 1040 with Schedule A (Itemized Deductions). On Schedule A, line 1 asks for medical and dental expenses. Enter the total amount you paid for home health care that qualifies as a medical expense. On line 2, enter 7.5 percent of your AGI (this figure is calculated from your Form 1040). Subtract line 2 from line 1 to get the amount you can deduct.

If you are using tax software, the program will walk you through these steps. If you are filing by hand or working with a tax professional, provide them with your receipts and documentation. A tax professional can help you determine which portions of your home health care costs may have access to and may support you are claiming only the deductible amount.

Keep a copy of your receipts and documentation with your tax records. If the IRS questions your deduction, you will need to show that the expenses were medical in nature and that you paid them.

State tax deductions for home health care

Some states allow additional deductions or credits for home health care costs that the federal government does not. A few states have programs that reduce taxes for people who care for elderly or disabled family members at home. The rules vary widely by state, so check your state's tax agency website or speak with a tax professional who knows your state's rules.

If you live in a state with an income tax, you may be able to deduct home health care on your state return even if you cannot deduct it federally, or vice versa. State and federal rules are not always the same. Some states follow the federal 7.5 percent threshold; others use a different threshold or allow deductions without a threshold at all.

Frequently Asked Questions

Can I deduct home health care if I pay for it with a Health Savings Account or Flexible Spending Account?

Yes. If you use a Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for may have access to home health care, that money comes out pre-tax and you do not need to deduct it on your tax return. The deduction happens at the point of payment. If you pay for home health care out of pocket after using up your HSA or FSA, you can deduct the remaining amount on Schedule A if it exceeds the 7.5 percent threshold.

What if my parent lives with me and I pay for their home health care?

You can deduct the cost of their home health care on your return if you claim them as a dependent and meet the other requirements. Your parent must have lived with you for the entire year, you must have paid more than half their total support, and their gross income must be below the threshold for the year. Keep documentation showing the relationship and that you paid for the care.

Can I deduct the cost of home health care for myself?

Yes, if the care is medical in nature and you itemize deductions. The same rules explore — the cost must exceed 7.5 percent of your AGI, and you must have documentation from the provider. You do not need to claim yourself as a dependent; you are deducting your own medical expenses.

Does Medicare cover home health care, and if so, can I still deduct it?

Medicare covers some home health care services, and you do not pay for those services — Medicare does. You can only deduct home health care costs that you paid out of pocket. If Medicare covers the full cost, there is nothing to deduct. If you pay a copay or coinsurance, you can deduct that amount if it meets the other requirements.

What if the home health care provider is not licensed?

The IRS generally requires that home health care be provided by a licensed professional or agency to be deductible. If you hire an unlicensed individual, the deduction is much harder to support. Some states require home health aides to be licensed; others do not. Check your state's rules and ask the provider about their credentials before hiring them if you plan to deduct the cost.