Is a home health aide tax deductible?

Nursing services versus household help

Home care in Pub 502 points to Nursing Services. You can include wages and other amounts you pay for nursing services, whether provided in your home or in another care facility. Examples named in the publication are giving medication or changing dressings, as well as bathing and grooming the patient. The services need not be performed by a nurse as long as they are of a kind generally performed by a nurse.

Household Help is on the not-includible list. The cost of household help is a personal expense that is not deductible, even if a doctor recommends the help. The publication points back to the nursing-services rules for any nursing-type work and to the long-term care rules for qualified maintenance or personal care.

Dividing the pay

When one attendant does both kinds of work, only the nursing portion is a medical expense. Pub 502 gives the method and an example: you pay a visiting nurse $300 per week for medical and household services, and ten percent of the time goes to household services such as washing dishes and laundry. You can include $270 per week, and the $30 allocated to household services cannot be included.

The calculator above runs exactly that allocation for your own weekly pay, household percentage and number of weeks. The publication leaves the measurement of time to you, so a simple log of tasks and hours is the best support.

Meals, upkeep and employment taxes

The attendant’s food can partly count. Pub 502 says to divide the food expense among the household members to find the cost of the attendant’s food, then divide that cost between medical and other services in the same way. If you paid extra for household upkeep because of the attendant, such as extra rent or utilities because you moved to a larger apartment to provide space, you can include the extra amounts.

If you employ the aide directly, you can include as a medical expense social security tax, FUTA, Medicare tax and state employment taxes you pay for an attendant who provides medical care. When the attendant also does personal and household work, only the employment taxes for the medical services count. The publication refers household employers to Pub 926.

Long-term care, and the dependent care alternative

For a chronically ill individual, qualified long-term care services include maintenance and personal care services provided under a plan of care prescribed by a licensed health care practitioner. An individual is chronically ill if, within the previous 12 months, a licensed health care practitioner certified that the person cannot perform at least two activities of daily living (eating, toileting, transferring, bathing, dressing, continence) without substantial assistance for at least 90 days, or needs substantial supervision because of severe cognitive impairment.

Separately, some costs for a disabled dependent may qualify either as medical expenses or as work-related expenses for the child and dependent care credit. Pub 502 says you may choose either way as long as the same expenses are not used for both. Illustration, not from the publication: a $400 weekly aide for 40 weeks with 15 percent household work leaves $13,600 of medical expense, to which the 7.5% of AGI floor then applies.

How the floor, timing and itemizing apply here

For home health aide, the same three rules from Publication 502 decide the final number. First, the deduction is only the part of your total medical and dental expenses that is more than 7.5% of your adjusted gross income, so a $1,000 cost does nothing until the year’s total passes the floor. Second, you include only what you paid during the tax year and were not reimbursed for, and you may include costs for yourself, your spouse and your dependents. Third, the deduction is claimed on Schedule A (Form 1040), so it helps only if your itemized deductions add up to more than your standard deduction. Amounts paid with a tax-free health savings account distribution cannot be counted again, and pre-tax flexible spending arrangement reimbursements are excluded.

Related medical expense topics

More from the same IRS publication: Is therapy tax deductible?, Is a wheelchair tax deductible?, Are funeral expenses tax deductible?. For a full calculation across all your expenses, use the medical expense deduction calculator.

Sources

• IRS Publication 502, Medical and Dental Expenses (2025): the “Nursing Services; Household Help” entries, the 7.5% of AGI rule, the reimbursement rules and the transportation rules. Read November 2, 2026.

Edition read: Publication 502 (2025), for use in preparing 2025 returns. Dollar limits and rates in this publication are for 2025; the publication notes that later legislation (P.L. 119-21) may affect federal deductions, so check the current publication and the Schedule A instructions for your tax year. This page summarizes the publication and does not replace it. Marked for human review.