Exactly as you say. Services that are medically necessary and ordered by the doctor will not only be covered by Medicare but also by most insurances. They can also be deducted as expenses on taxes too. Services that are not medically necessary like companions, sitters, housekeepers, landscapers are not covered and can't be claimed. Insurance will not cover domestic servants. They aren't a tax deduction either if you hire some privately. With a nursing home, they don't make their huge money off of medically necessary services. They make it off of room and board. The room and board is paid by insurance for a period of time, while the person needs skilled nursing care. Once it's determined that the person no longer needs it, the bill has to start getting paid in cash sometimes $10,000 and $15,000 a month, unless the person is on Medicaid already. When they go completely broke, the nursing home gets them on Medicaid who then pays.
Again, Medicare does not cover personal care services such as bathing, dressing, feeding even if necessary as determined by a Dr. but these services provided at home may be deductible as a medical expense on taxes, which is what the original OP is asking about, as covered in the IRS publication. You are correct that Medicare will cover a certain number of days in a SNF (skilled nursing facility) if the stay is required because of an acute condition such as surgery or illness and the person is receiving rehab services. And you are also correct that after that period is up, if the person still cannot be on their own at home and needs a NH level of care the person would have to be self pay until their assets are exhausted and then Medicaid could take over payment (assuming the person met both medical and income requirements to be Medicaid eligible).
No. It's not a tax deduction. It's sort of like nursing home rules. Medicare and secondary insurance pays for whatever is medically necessary for a resident of a care facility. They do not pay for room and board or companionship. Medicare would have paid for your parent's visiting nurse service. They will also pay for a few hours of CNA service per week for things like bathing and other personal hygiene services. These services would not have had to of been paid out of pocket by anyone. I've been in private-pay homecare service for a long time and your question gets asked often. If you hired additional services and paid for them out of pocket that is not a tax deduction. Even if you used a care agency. Companions, housekeepers, sitters, errand runners, nannies, landscapers, etc... are domestic servants. A person cannot claim their servants wages on their taxes. Look on the bright side. You didn't actually pay for anything. You paid for your parent's care using your parent's money. Read some of the stories on this forum about people practically going bankrupt paying for the care of their elderly parents themselves.
I respectfully disagree. If you review the IRS publication BarbBrooklyn and I cited, you'll see that long term care services are deductible, including some services received at home if medically necessary and with a Dr.'s order--and that includes personal care services such as bathing, dressing, toileting, feeding, etc. In addition, Medicare does not pay for long term care services in facilities, though it does cover things such as doctors' visits, some PT, etc. The only time Medicare pays for services in a nursing home (SNF) is if this is a skilled level of care after an acute illness or injury, and then only for a limited period of time. Medicaid, however, does cover LTC in facilities.
If someone is in a nursing home because of medical necessity, the entire cost is deductible as a medical expense. The NH does not send bills that break down cost categories. Home care is a little less clear, but I think a good part of it may be deductible as a medical expense on your parent's taxes. One of the key elements is that the person must be chronically ill and that the services are needed per a Dr.'s order. See: https://www.irs.gov/pub/irs-pdf/p502.pdf Note the section in there on long term care.
A nursing home will send a bill broke down into as you say, cost categories if you tell them to. They did for my father because I insisted. If they are in the nursing home and it's medically necessary for them to be, insurance will pay. If they are on Medicare, it will be paid for 100% because their secondary insurance will pick up the rest. Room and board care or custodial care are not paid for in a nursing home unless a person has a good LTC policy. The only time they get paid for is after the nursing home has eaten up everything the person ever had and they go on Medicaid. The same rules apply for homecare. Whatever their doctors order as medically necessary will be paid for by insurance. They do not pay for companionship or housekeeping.
Thanks, Barb. I found the post quite confusing. And you corrected me so compassionately, not at all confrontational which we see so often on this site. Hugs.
Was the care though a home care service company? If so, then taxes would have been withheld if these were under the table cash workers then my guess would be no. Read the publication Barb recommends.
But I don't know if you can deduct for someone that you do not claim as a dependent. I wonder if there maybe gift tax implications.
IRS defines a dependent as a qualifying child under age 19 (or under 24 if a full-time student) or a qualifying relative who makes less than $4,300 a year (tax year 2021). A qualifying dependent may have a job, but you must provide more than half of their annual support..
The medical parts of services can be deducted, not housekeeping or companionship. You figure out what percentage was "medical--there is some guidance in the publication--and you deduct that.
Exactly as you say. Services that are medically necessary and ordered by the doctor will not only be covered by Medicare but also by most insurances. They can also be deducted as expenses on taxes too.
Services that are not medically necessary like companions, sitters, housekeepers, landscapers are not covered and can't be claimed. Insurance will not cover domestic servants. They aren't a tax deduction either if you hire some privately.
With a nursing home, they don't make their huge money off of medically necessary services. They make it off of room and board. The room and board is paid by insurance for a period of time, while the person needs skilled nursing care. Once it's determined that the person no longer needs it, the bill has to start getting paid in cash sometimes $10,000 and $15,000 a month, unless the person is on Medicaid already. When they go completely broke, the nursing home gets them on Medicaid who then pays.
Medicare and secondary insurance pays for whatever is medically necessary for a resident of a care facility. They do not pay for room and board or companionship.
Medicare would have paid for your parent's visiting nurse service. They will also pay for a few hours of CNA service per week for things like bathing and other personal hygiene services. These services would not have had to of been paid out of pocket by anyone.
I've been in private-pay homecare service for a long time and your question gets asked often.
If you hired additional services and paid for them out of pocket that is not a tax deduction. Even if you used a care agency. Companions, housekeepers, sitters, errand runners, nannies, landscapers, etc... are domestic servants. A person cannot claim their servants wages on their taxes.
Look on the bright side. You didn't actually pay for anything. You paid for your parent's care using your parent's money.
Read some of the stories on this forum about people practically going bankrupt paying for the care of their elderly parents themselves.
If they are in the nursing home and it's medically necessary for them to be, insurance will pay. If they are on Medicare, it will be paid for 100% because their secondary insurance will pick up the rest.
Room and board care or custodial care are not paid for in a nursing home unless a person has a good LTC policy. The only time they get paid for is after the nursing home has eaten up everything the person ever had and they go on Medicaid.
The same rules apply for homecare. Whatever their doctors order as medically necessary will be paid for by insurance. They do not pay for companionship or housekeeping.
In an AL or NH, you get a statement of what you can deduct.
But I don't know if you can deduct for someone that you do not claim as a dependent. I wonder if there maybe gift tax implications.
IRS defines a dependent as a qualifying child under age 19 (or under 24 if a full-time student) or a qualifying relative who makes less than $4,300 a year (tax year 2021). A qualifying dependent may have a job, but you must provide more than half of their annual support..
The medical parts of services can be deducted, not housekeeping or companionship. You figure out what percentage was "medical--there is some guidance in the publication--and you deduct that.