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I am hiring part time help for bathing ,toileting and walking for my chronically sick husbsand. isthis cost tax deductible or out of pocket expence

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Medical expenses must be 10% over AGI to be able to be claimed on your tax returns (fed and state).
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When I took my friend in for his taxes last year, I learned that all the expenses of his memory care apartment, food, etc, were tax deductible, as were the Visiting Angels' expenses for his wife's care before they got into the AL/MC unit. Since their added up expenses were greater than their income, no tax obligation existed that year. If the tax preparer tells me the same thing this year, I will no longer have state and federal taxes withheld from his income. I am keeping good records still, though, to document those expenses.
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If the services to be provided are "medically necessary" for your husband and you pay for them yourself, if you itemize deductions on your tax return you can factor those fees in. Make sure you keep meticulous records just in case of an audit.
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It is best to check but if these things can not be handled by your husband or yourself (safely) they might be. I have my taxes done and I was able to deduct portions of Adult Day Care as well as some Respite care. I was also able to deduct a piece of equipment that I purchased.
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Contact a tax expert or CPA who has expertise in this area or an elder law attorney. As freqflyer pointed out, it is a complicated question.
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Your best bet is to contact a CPA or income tax expert as there are many variables involved.
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