Tax

Have a Tax Question? Ask a Tax Expert

Ask an Expert,
Get an Answer ASAP!

Tax
This answer was rated:

Currently I have hired a senior care agency to care for my

wife in our home....
Currently I have hired a senior care agency to care for my wife in our home. I would like to treat this expense as a medical expense and take a tax deductions.

Q. What steps must I take to qualify my "in-home" senior caregiver expense as a tax deductable medical expense ?

As I understand the IRS Publication 502 (pg. 12 ) , I will need a letter from a doctor stating that my wife is 1) chronically ill individual 2) provides a plan of care which includes the hiring of caregivers but in my case not a nurse (RN). The caregiver(s) will need to provide substantial supervision to protected my wife from threats to her health and safety due to severe cognitive impairment. To me it means the caregivers must be by wife side at all times as she walks about the house. Prevent her from walking upstairs or outside, dispense medication as scheduled, help her shower, help her get out of the chair or bed, help her change clothes, change bedding and eat.

I am assuming her family doctor will not know all the in and outs of writing a letter(s) that will satisfy the IRS. As such the correct answer to my question will include either a form letter or a sample letter that I can give to her doctor to help him write/included all the necessary elements for the IRS to qualify my expense as a medical expense.

Background:

My wife's cognitive functions has degraded to point that I do not feel it is safe for her to be left alone. My wife is 76 years of age. Chronically ill, Eighteen years ago she was diagnose with Lupus which has taken a toll on her body. She would not be able to live alone for she no longer drives a car, shops, cooks or cleans the house. She needs help to shower. She is not stable on her feet and on her better day has problems walking more than 15 feet at a time.( she has falling 4 times at home in the last two months - two of her falls resulted in 911 calls and a trip to ER ). Some days she needs help getting out of her chair. Her mental state is not consistence. At times during the day she can appear to be normal but there are other times during the day especially at night she has the classic the signs dementia:

a) memory loss -- she may or may not know her street address or her phone number , or even the location of bathroom in her house
b) difficulty performing familiar task -- dial a phone or operation the TV system
c) language problems - - she can not find the right words for to describe a simple task ... if she is hot and wants the air conditioning adjusted to a lower temperature she is not always able to instruction the caregiver to lower the temperature.
d) poor judgment - - on several occasions she took her pillow and blanket waked out side at night to sleep by the pond or in the car.
e) medications - - on several occasion she taken double dose of her medications , a few times she has taken medication out of the prescription bottles and hid their contents. ( I can no longer trust her to take medications at the correct time or take the correct amount. All her medications are now under lock and key and disbursed by me or by the caregiver from the agency).
f) change in moods - - crying for no apparent reason and/or fearful of husband, son and caregivers.

Note: At this point in time I don't believe my wife has been officially diagnosed by her doctor as having dementia. However When my wife was questioned by the nurse in the hospital and at home she was not able to answer correctly simple questions related to the time of day and names of family members or her address. No sure if these observations were reported to her family doctor. If for some reason her doctor will not diagnose her as demented or severely cognitive impaired, what should I do? or who should I contact? Does the IRS does specify it has to be by a her family doctor or will any medical professional do?
Show More
Show Less
Ask Your Own Tax Question
Answered in 30 minutes by:
8/18/2013
Barbara
Barbara, Enrolled Agent
Category: Tax
Satisfied Customers: 4,030
Experience: 20+ years of experience in tax preparation; 30+ years of experience as a real estate/corporate paralegal.
Verified

Welcome and thank you for giving me the opportunity to assist you with your tax question.

 

You may take these caregiver expenses as deductible medical expenses if the following criteria is met:

 

To be deductible, a medical expense must be paid with after-tax, out-of-pocket
dollars. The expense must also be for treatment of a medical issue, not just for
maintaining good health. These expenses must be in excess of 7.5% of your adjusted gross income. Of course, if the caregiver provides housekeeping, cooking or other such services, that portion is not deductible.

 

Publication 502 is clear in that it specifically states:

 

Qualified long-term care services are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, rehabilitative services, and maintenance and personal care services (defined later) that are:

Required by a chronically ill individual, and


Provided pursuant to a plan of care prescribed by a li-censed health care practitioner.

 

Further, ANY licensed health care practitioner can certify that your wife meets either of the following descriptions.

 

She is unable to perform at least two activities of daily living without substantial assistance from an-other individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence.

 

She requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

 

Based on the information contained in your question, it would seem the in-home care in your home is deductible as a medical expense.

 

Please let me know if you require further information or clarification.

 

Thank you and best regards,

Barb

Ask Your Own Tax Question
Customer reply replied 4 years ago

Since I already have access to the IRS Publication 520 I was looking for something beyond a few statements taken from the IRS Publication. I was hoping to see actual examples of supporting documents to validate the tax deductions like letter submitted to the IRS by doctors description the medical conditions (cognitive impairment and the corresponding plan of care ).


 



to put it another way if i wanted a person to supply me a chair, I would need more than bare bone description of a chair but an actual picture of chair with a diagram showing details dimensions. Your answer was a bare bone IRS description lacking an actual example of a real letter from a doctor nor a real world plan of care ( the diagram showing details). To be fair the detailed answer would require more research on your part and in turn a higher level of compensation .... if you are able to supply the details and or examples I will be willing go up to $60, but as it stands now your answer falls short of what I was hoping to see.

taxmanrog
taxmanrog, Certified Public Accountant (CPA)
Category: Tax
Satisfied Customers: 777
Experience: Licensed CPA, MA, MST with 31 years' experience. Teach Accounting and Tax courses at Masters level.
Verified
Welcome to Just Answers! The expert you requested is not online right now, so with your permission, I will try to assist you. I will do my best to help!

It has been my experience over the past 28+ years that you just need some documentation for your files when claiming this deduction. The doctor does not have to send anything to the IRS in advance of any questions. The IRS may not even question the deduction, but in the event they do, having a letter in your files that you can send to the IRS to confirm the medical expense will in all likelihood satisfy their questions.

The doctor can write a letter addressed to the IRS, but give it to you to keep in your tax files. The letter should be something as follows:

Date

Internal Revenue Service

(Appropriate Service Center)

Regarding: Patient Name

Date of Birth

Social Security Number

Dear Sir or Madam:

I am writing this letter to confirm the necessity of Home Health Care for my patient [name of patient], who has the following diagnoses relevant to this service: [list diagnoses]

This service is medically necessary for the following reasons: [list the reasons that you outlined above].

It will, or is reasonably expected to, prevent future injury, and to provide assistance to the patient in areas where she is unable to care for herself since the onset of this illness, condition, or disability. [List potential problems and the benefits of the health care provider]

It will, or is reasonably expected to, reduce or ameliorate the physical, mental, or developmental effects of an illness, injury, or disability. [Please provide details]

It will assist the individual to achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the individual and those functional capacities that are appropriate for individuals of the same age. It will also reduce the chance of further injury and note the progression of the illness that might otherwise not be observed. [Please provide details.]

Please let me know if you require additional information from my records.

Yours truly,

Doctor’s Name


I believe that this is what you were looking for. If you have any questions, please let me know. If you have found this helpful, please rate me highly! I would appreciate it!

Thanks! Have a great weekend!

Roger
taxmanrog
taxmanrog, Certified Public Accountant (CPA)
Category: Tax
Satisfied Customers: 777
Experience: Licensed CPA, MA, MST with 31 years' experience. Teach Accounting and Tax courses at Masters level.
Verified
taxmanrog and 87 other Tax Specialists are ready to help you
Ask your own question now
Ask taxmanrog Your Own Question
taxmanrog
taxmanrog
taxmanrog, Certified Public Accountant (CPA)
Category: Tax
Satisfied Customers: 777
777 Satisfied Customers
Experience: Licensed CPA, MA, MST with 31 years' experience. Teach Accounting and Tax courses at Masters level.

taxmanrog is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I really was impressed with the prompt response. Your expert was not only a tax expert, but a people expert!!! Her genuine and caring attitude came across in her response...

T.G.WMatteson, IL

I WON!!! I just wanted you to know that your original answer gave me the courage and confidence to go into yesterday's audit ready to fight.

BonnieChesnee, SC

Great service. Answered my complex tax question in detail and provided a lot of additional useful information for my specific situation.

JohnMinneapolis, MN

Excellent information, very quick reply. The experts really take the time to address your questions, it is well worth the fee, for the peace of mind they can provide you with.

OrvilleHesperia, California

Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help.

Mary C.Freshfield, Liverpool, UK

This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!!

AlexLos Angeles, CA

Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult.

GPHesperia, CA

< Previous | Next >

Meet the Experts:

Wallstreet Esq.

Wallstreet Esq.

Tax Attorney

586 satisfied customers

10 years experience

Mark D

Mark D

Enrolled Agent

1,300 satisfied customers

MBA, EA, Specializing in Business and Individual Tax Returns and Issues

Richard

Richard

Tax Attorney

4,310 satisfied customers

29 years of experience as a tax, real estate, and business attorney.

Robin D.

Robin D.

Senior Tax Advisor 4

13,695 satisfied customers

15years with H & R Block. Divisional leader, Instructor

Megan C

Megan C

Certified Public Accountant (CPA)

8,651 satisfied customers

Licensed CPA, CFE, CMA, CGMA who teaches accounting courses at Master's Level

jgordosea

jgordosea

Enrolled Agent

2,885 satisfied customers

I've prepared all types of taxes since 1987.

R. Klein, EA

R. Klein, EA

Enrolled Agent

1,839 satisfied customers

Over 20 Years experience

< Previous | Next >

Related Tax Questions
If lease payments are being taken as a tax deduction can the
If lease payments are being taken as a tax deduction can the mileage method be used to account for other expenses? Or are you required to use actual expenses?… read more
Robin D.
Robin D.
Senior Tax Advisor 4
Vocational, Technical or Trade School
13,695 satisfied customers
Form 886-A Deductible Home Mortgage Interest Taxpayer has
Form 886-A Deductible Home Mortgage Interest Taxpayer has $1,000,000 in Grandfathered debt. Line 9 Form 886-A - is this line amount after deducting the garandfathered debt… read more
NPVAdvisor
NPVAdvisor
CFP Licensee and Practitioner
Master's Degree
180 satisfied customers
Dose mean can not deduct state income taxes only or dose it
dose mean can not deduct state income taxes only or dose it includes property taxes too … read more
NPVAdvisor
NPVAdvisor
CFP Licensee and Practitioner
Master's Degree
180 satisfied customers
I need a form to apply to have 10% of my SS check deducted.
I need a form to apply to have 10% of my SS check deducted … read more
Barbara
Barbara
Enrolled Agent
4,030 satisfied customers
Form 1120, cash basis. If Taxes paid to IRS are deductible,
Form 1120, cash basis. If Taxes paid to IRS are deductible, are refunds for overpayment the equivalent of income?… read more
Chad CFP ®
Chad CFP ®
Certified Financial Planner(R), Pro
Master\u0027s Degree
723 satisfied customers
I'm looking for help with tax deductions. I will be
I will be receiving a large lump sum this year. I want to know if there is a limit to how much state tax I can deduct for federal filing? … read more
emc011075
emc011075
Senior Tax Specialist
Bachelor's Degree
16 satisfied customers
Is "Medicare Part" premiums deductable if so where do I find
Is "Medicare Part B" premiums deductable if so where do I find the proper question in Turbotax? I used Turbotax… read more
Wallstreet Esq.
Wallstreet Esq.
Tax Attorney
Doctoral Degree
586 satisfied customers
Two questions on federal tax deductibility: 1. We personally
Two questions on federal tax deductibility: 1. We personally paid legal fees for our manufacturer C Corp. The fees were for assistance in preparing a Research & Development tax credit application. Can… read more
NPVAdvisor
NPVAdvisor
CFP Licensee and Practitioner
Master's Degree
180 satisfied customers
You may recall that tax deductions are only deductible by
You may recall that tax deductions are only deductible by the legislative grace of Congress. After this lesson, you might have realized that Congress was pretty generous with the types of business exp… read more
Barbara
Barbara
Enrolled Agent
4,030 satisfied customers
Can the Internal Revenue Service Audit an Amended 1040 after
Can the Internal Revenue Service Audit an Amended 1040 after the statue of limitations expire ? If so , can you specify why and the federal statue in the Library Of Congress that allows the examinatio… read more
PDtax
PDtax
Owner
Master\u0027s Degree
1 satisfied customers
Are medical equipment purchesed tax deductable. I have been
I have been prescribed a portable oxygen generator is this equipment deductable … read more
abci168
abci168
Principal
27 satisfied customers
Can house maintenance and property taxes be deducted on form
Hello. Can house maintenance and property taxes be deducted on form 1041 for a house owned by decedent prior to the Executors selling it? … read more
NPVAdvisor
NPVAdvisor
CFP Licensee and Practitioner
Master's Degree
180 satisfied customers
A question about mortgage deduction: if person A helps
A question about mortgage deduction: if person A helps person B take a loan to help this person B buy a primary residence, who gets the right to deduct the mortgage interest for tax filing? Person A m… read more
emc011075
emc011075
Senior Tax Specialist
Bachelor's Degree
16 satisfied customers
I bought an IRA thinking it was deductible but the IRS added
I bought an IRA thinking it was deductible but the IRS added more income now the IRA is not deductible. Will the IRS treat it as income if I cash it in considering they disallowed it on my 2015 tax re… read more
emc011075
emc011075
Senior Tax Specialist
Bachelor's Degree
16 satisfied customers
Is there a way to carry over medical expenses to subsequent
Is there a way to carry over medical expenses to subsequent years taxes? I know the answer is typically no but we will have very high expenses. Specifically, we will have roughly $1.5 million in medic… read more
NPVAdvisor
NPVAdvisor
CFP Licensee and Practitioner
Master's Degree
180 satisfied customers
I would like clarification on the IRS tax deductions and a
I would like clarification on the IRS tax deductions and a rental property I purchased recently. … read more
Robin D.
Robin D.
Senior Tax Advisor 4
Vocational, Technical or Trade School
13,695 satisfied customers
Turbo tax states we need $8469 in medical expenses. We have
Turbo tax states we need $8469 in medical expenses. We have $10736.00 in medical expenses. Turbo Tax states we do not qualify, why?… read more
LEV
LEV
Retired
Bachelor's Degree
14,896 satisfied customers
Deductible medical expenses - I have two questions
Deductible medical expenses -Good Afternoon,I have two questions concerning medical expenses.1) If a doctor writes a prescription for a patient to hire a personal trainer to have him exercise x times … read more
Robin D.
Robin D.
Senior Tax Advisor 4
Vocational, Technical or Trade School
13,695 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x