Home health care can be tax deductible in the U.S., but only certain types of care and only if you itemize medical expenses instead of taking the standard deduction. The key test is whether the services qualify as medical or long‑term care expenses under IRS rules, not just general household help.

Core rule: what’s deductible?

In general, home health care expenses are deductible as medical expenses if they are:

  • Primarily to diagnose, treat, mitigate, or prevent a disease, or for qualified long‑term care.
  • Unreimbursed (not covered by insurance or another program).
  • Claimed on Schedule A when you itemize deductions, and only to the extent total medical expenses exceed 7.5% of adjusted gross income (AGI).

Nonmedical help (like light housekeeping, meal prep, or pet care) is usually not deductible unless it’s part of a prescribed long‑term care plan for someone who is chronically ill.

Home care vs. home health care

These terms show up a lot in tax and elder‑care discussions, and they matter for deductibility.

  • Home health care
    • Typically skilled medical services (nursing, physical therapy, wound care, medication injections, etc.).
* Often prescribed by a doctor and provided by licensed professionals.
* Usually treated as medical expenses and therefore eligible if other conditions are met.
  • Home care (nonmedical)
    • Help with activities of daily living (ADLs) such as bathing, dressing, toileting, transferring, eating, and continence.
* May also include instrumental activities of daily living (IADLs) like cooking, cleaning, errands, and transportation.
* Only deductible in limited circumstances—most commonly when the person is “chronically ill” and a licensed health professional has certified the need for substantial assistance with at least two ADLs for at least 90 days, or the person needs supervision due to cognitive impairment.

Key IRS-style requirements

Most guides base their explanations on IRS Publication 502 and the qualified long‑term care rules. Typical requirements:

  • The person receiving care is chronically ill (e.g., needs substantial help with ADLs or requires supervision for cognitive issues).
  • A doctor, nurse, or other licensed health care professional has prescribed the care as part of a written plan of care.
  • The services are the type the IRS recognizes as medical or qualified long‑term care—such as:
    • Nursing visits and skilled therapies
    • Medication management and injections
    • Wound care
    • Assistance with ADLs for someone who meets the chronic‑illness standard

General companionship or household chores that are not tied to medical need are typically not deductible.

Examples of likely deductible vs. not

Many tax and caregiving resources give similar practical examples.

Often deductible (if prescribed and unreimbursed):

  • Skilled nursing visits at home (monitoring vitals, administering treatments).
  • Physical, occupational, or speech therapy delivered at home.
  • Assistance with bathing, dressing, toileting, or eating for a chronically ill person under a written care plan.
  • Certain medical supplies and equipment used at home, like wound dressings, walkers, blood sugar monitors, and similar items.

Usually not deductible:

  • Housekeeping, laundry, lawn care, and routine meal prep for someone who does not meet the chronic‑illness standard.
  • Errands, shopping, and purely social companionship not clearly tied to medically necessary long‑term care.

Some states also allow the medical portion of home health care as a deduction or credit on state income tax returns, but rules differ widely.

Practical steps before tax time

Current guides aimed at families recommend a few consistent steps to avoid missing or mis‑claiming deductions.

  • Keep itemized invoices from agencies or caregivers that clearly separate medical and nonmedical services.
  • Obtain and retain written documentation from a doctor or licensed health professional stating:
    • Diagnosis or chronic condition
    • Need for assistance with specific ADLs, or cognitive‑impairment supervision
    • Prescribed plan of care and duration
  • Track all unreimbursed costs you pay for yourself, a spouse, or a dependent, including premiums for some long‑term care insurance, if applicable.
  • Check whether your total medical expenses will exceed 7.5% (for federal) of your AGI so itemizing is likely to help.

Because the rules are technical and change over time, many caregiving and senior‑care sites strongly advise talking with a tax professional familiar with medical and long‑term care deductions before filing.

Bottom note: Information here reflects public internet sources and should not be taken as individualized tax, legal, or financial advice.