Are Assisted Living and Nursing Home Expenses Tax Deductible?

Nursing home and assisted living expenses can be tax deductible: for a taxpayer who itemizes, a senior's unreimbursed medical costs above 7.5% of adjusted gross income are deductible. Costs from nursing home care to in-home nursing services count, but assisted living counts only for the part that meets one of the IRS's medical tests. The same medical-expense deduction can also cover premiums on a qualified long-term care insurance contract, up to a cap based on age.1 Tax deductions for senior care can reach a parent's costs too: you may be able to deduct the medical bills you paid on their behalf, or claim an aging parent as a dependent.

Tax rules are specific, so confirm your own situation with a tax professional.

Are Assisted Living and Nursing Home Expenses Tax Deductible?

They can be. Two routes get nursing home and assisted living expenses into the medical expense deduction, and each has its own test. Either way, you have to itemize, and only your unreimbursed medical expenses above 7.5 percent of your adjusted gross income count.1

Route one: the stay is for medical care. The cost of medical care in a nursing home, home for the aged, or similar institution is a medical expense. Meals and lodging count too when a principal reason for being there is to get medical care. If the reason for being there is personal, only the part of the cost that is for medical or nursing care counts.1

Don't assume an assisted living residence is treated as a similar institution. Ask a tax professional how yours is treated.

Route two: the resident is chronically ill. Qualified long-term care services count, including maintenance and personal care. The resident has to be certified as chronically ill, and the services have to be provided under a plan of care prescribed by a licensed health care practitioner.1 On this route, what counts is the cost of those services. The certification test is spelled out in the next section.

What to ask the residence for. Ask for a written statement that splits its fee between medical or nursing care and everything else. If the resident is chronically ill, get copies of the practitioner's certification and the plan of care too. Keep them with your tax records.

The same deduction covers in-home nursing care and, up to a cap, premiums on a qualified long-term care insurance contract.1

How Much of an Assisted Living or Nursing Home Bill Is Tax Deductible?

Only the qualifying part above 7.5% of your adjusted gross income, and only if you itemize. That is the medical expense deduction, the main one of the tax deductions for senior care. It's claimed on Schedule A (Form 1040).1 It only helps if your total itemized deductions beat your standard deduction, so add up Schedule A and compare the two before you count on it. The 2026 standard deduction amounts are further down this section.

Here's the rule. You can deduct unreimbursed medical and dental expenses, but only the portion that exceeds 7.5% of your adjusted gross income.1 Everything below that floor isn't deductible. If dental work is a big part of the year's bills, our guide to where seniors find affordable dental care covers ways to lower the bill itself.

The math is simple. As an illustration, say your AGI is $80,000. The floor is $6,000. If you paid $20,000 in qualifying medical costs, you deduct $14,000. The first $6,000 doesn't count.1

According to IRS Publication 502, a wide range of senior-care costs qualify. The ones that matter most for families:

• Nursing home or similar institution. The cost of medical care there counts, under the route-one rule above.1
• Life-care or founder's fees. If you pay a retirement home a life-care fee or founder's fee, monthly or as a lump sum, you can include the part that is properly allocable to medical care. The agreement has to require a specific fee as a condition for the home's promise of lifetime care that includes medical care. A statement from the home can prove the medical share, and it has to be based on the home's prior experience or on information from a comparable home.1
• In-home nursing-type care. Wages you pay for nursing services count, and the services need not be performed by a nurse, as long as they are the kind a nurse generally performs. If the same aide also provides household or personal services, you split the pay by time, and generally only the nursing share counts. The IRS's own example: a visiting nurse paid $300 a week who spends 10 percent of the time on dishes and laundry yields $270 a week that counts. Part of the aide's meals and any extra rent or utilities you pay because of the aide can be added, and certain personal care provided as qualified long-term care (the next item) can be included anyway.1
• Qualified long-term care services. Maintenance and personal care count too, but only for a chronically ill person under a plan of care prescribed by a licensed health care practitioner. Chronically ill means a practitioner certified, within the previous 12 months, that the person can't perform at least two of six activities of daily living (eating, toileting, transferring, bathing, dressing, continence) without substantial help for at least 90 days, or needs substantial supervision because of severe cognitive impairment. A parent with dementia can meet the test that second way, if a practitioner certifies that they need substantial supervision because of severe cognitive impairment.1
• Long-term care insurance premiums. Premiums count only if they are paid for a qualified long-term care insurance contract, and then only up to an age-banded cap that rises as you get older.1

Rent in HUD-assisted housing runs on its own medical expense rule, which our guide to how HUD calculates a senior's rent explains.3

The long-term care premium caps

Not every long-term care policy qualifies. The premiums count as a medical expense only if they are paid for a qualified long-term care insurance contract: one that covers only qualified long-term care services and that, among other requirements, is guaranteed renewable and has no cash surrender value or other money that can be paid out, assigned, pledged, or borrowed. Ask the insurer whether your policy is a qualified contract before you count the premium. Even then, the IRS caps how much counts based on your age at year-end.1 For 2026, the limits are:

The limit is per person, so each spouse has their own. These are the 2026 limits, so check the current year's figures before you file. They still sit on top of the 7.5% AGI floor, so the premium has to clear that threshold along with your other medical costs.1 Our guide to how long-term care insurance works covers the policy side in detail.

Should You Itemize or Take the Standard Deduction?

The standard deduction is a dollar amount that reduces your taxable income. You take it instead of itemizing, and a taxpayer who doesn't itemize gets no medical deduction. The IRS's guidance is to itemize if your total deductions are more than your standard deduction amount.1 For tax years beginning in 2026, the amounts are:

If you're 65 or older. You're entitled to a higher standard deduction if you're 65 or older on the last day of the year and don't itemize. The IRS counts you as 65 on the day before your 65th birthday. For 2026, the additional amount for the aged or the blind is $1,650, or $2,050 if you're also unmarried and not a surviving spouse. You can take the higher deduction for a spouse who is 65 or older or blind if you file a joint return, or if you file a separate return and your spouse had no gross income and can't be claimed as a dependent by another taxpayer. You can't take it for anyone other than yourself and your spouse, so a parent's age adds nothing to your own standard deduction.1

When the standard deduction is zero. Not everyone gets one. Per the IRS, your standard deduction is zero, and you should itemize any deductions you have, in three cases: you're married filing separately and your spouse itemizes; you're filing for a short tax year because of a change in your annual accounting period; or you're a nonresident or dual-status alien during the year.1

An illustration. Take the example above, with $14,000 of medical costs left after the 7.5% floor. Say you file a 2026 return as an unmarried individual and that $14,000 is your only itemized deduction. It's less than the $16,100 standard deduction, so itemizing wouldn't help you.1

Claiming a Parent as a Dependent

If you support an aging parent, you may be able to claim them as a dependent. The IRS calls this a "qualifying relative." Two tests do most of the work.

The gross-income test. Your parent's gross income for the year has to be less than $5,300 for 2026, a figure indexed each year.1 Gross income means income that isn't exempt from tax, and only the taxable portion of Social Security benefits counts. Social Security that isn't taxable doesn't count against the limit.1

The support test. You have to provide more than half of your parent's total support for the year.1

A parent doesn't have to live with you to be your qualifying relative, according to IRS Publication 501.4 A parent in their own home or a facility can still be your dependent, as long as every other test here is met.

Siblings can share the support test. If several siblings together provide more than half a parent's support, none does it alone, and each of you could otherwise claim the parent, you can use a multiple support agreement to let one sibling claim the parent. Only one of you can claim, it has to be someone who individually provides more than 10% of the support, and the others sign statements agreeing not to.1 Collect those signed statements before you file. The sibling who claims the parent keeps them for their own records and attaches to the return a multiple support declaration identifying each of the others who agreed not to claim. Form 2120, Multiple Support Declaration, can be used for this.1

Three more tests apply on top. Even a parent who passes both tests can be claimed only if the dependent taxpayer test, the joint return test, and the citizen or resident test are also met. The joint return test is the one that catches families supporting two married parents: you generally can't claim a married parent who files a joint return, unless the couple files it only to claim a refund of tax withheld or estimated tax paid.1 Failing it costs you the dependency claim, not the medical-bills deduction described below.

Tax Credits for Senior Care

Two credits can apply when you support a parent. One requires that your parent be your dependent. The other has its own test. Credits beat deductions dollar for dollar, because they cut your tax bill directly instead of cutting taxable income.

The Credit for Other Dependents

If your parent qualifies as your dependent, you may be entitled to the credit for other dependents, which is available for each qualifying relative.1 It applies to dependents who don't qualify for the Child Tax Credit, which is the case for an adult parent.

The credit is worth up to $500 for each dependent. The IRS describes it as non-refundable, so it can reduce the tax you owe but isn't paid out as a refund beyond that. It starts to shrink once your adjusted gross income passes $200,000, or $400,000 if you're married filing jointly.2

Your parent has to be claimed as a dependent on your return and be a U.S. citizen, U.S. national, or U.S. resident alien. They also need a Social Security number, an Individual Taxpayer Identification Number (ITIN), or an Adoption Taxpayer Identification Number (ATIN).2

The Child and Dependent Care Credit

This credit isn't just for kids. It can apply to an adult who is physically or mentally unable to care for themselves.1

Here's how it works, per IRS Publication 503. If you (and your spouse, if filing jointly) have earned income and pay for your parent's care so you can work or look for work, you may be able to claim a credit on those care costs. The expenses used to figure it are capped at $3,000 for one qualifying person or $6,000 for two or more. Those are the caps in the IRS publication for 2025 returns, so check the current year's instructions before relying on them.1

The credit is a percentage of those expenses, not the full amount, and the percentage depends on your adjusted gross income. In the IRS publication for 2025 returns, the table runs from 35% where adjusted gross income is not over $15,000 down to 20% where it is over $43,000, with steps in between. Those are the percentages for 2025 returns. This guide doesn't carry percentages for 2026 returns, so check the instructions for the year you're filing.1

The parent has to have lived with you for more than half the year and be your dependent, or would have been except for the gross-income, joint-return, or claimed-as-someone-else's-dependent tests.1

How you claim it. On a 2025 return, you complete Form 2441 and attach it to your Form 1040, 1040-SR, or 1040-NR, then enter the credit on Schedule 3 (Form 1040), line 2. The credit is limited to your tax. You can't get a refund for any part of it above that limit.1

If you're married. In the IRS publication for 2025 returns, married couples generally must file a joint return to take the credit. If you're legally separated or living apart from your spouse, you may be able to file a separate return and still take it. You aren't considered married if you're legally separated under a decree of divorce or separate maintenance. You also aren't considered married, and are eligible to take the credit, if all four of these apply: you file a return apart from your spouse, your home is the home of a qualifying person for more than half the year, you pay more than half the cost of keeping up your home for the year, and your spouse doesn't live in your home for the last 6 months of the year.1

You can't use the same dollars twice. Some costs of caring for a person who can't care for themselves may qualify both as work-related expenses for this credit and as medical expenses. You can use them either way, but you can't use the same expenses to claim both the credit and the medical expense deduction. If you use them to figure the credit and they come to more than the earned income limit or the dollar limit, you can add the excess to your medical expenses. If you use your total expenses to figure the medical deduction, you can't use any part of them for the credit.1

You Can Deduct a Parent's Medical Bills Even If You Can't Claim Them

Your parent's income might be too high to claim them as a dependent. Any income that isn't exempt from tax counts toward the limit, so a taxable pension can push a parent over it. That doesn't shut you out of the medical deduction.1

According to IRS Publication 502, you can include in your own deductible medical expenses the medical costs you paid for a parent who would have been your dependent except for the gross-income test, the joint return test, or because you could be claimed as someone else's dependent. The same holds if you're treated as providing over half their support under a multiple support agreement.1 In plain terms: if your parent passes the support test but flunks the gross-income test, the medical bills you paid for them still count on your return.

So if you covered $15,000 of a parent's qualifying nursing home or nursing-care costs, that amount joins your own medical expenses and counts toward clearing your 7.5% AGI floor. The income test blocks the dependency claim and the credit that comes with it, not the medical deduction.1

The Senior-Care Tax Breaks at a Glance

Here's how the breaks line up. The deduction and the medical-bills rule reduce taxable income; the two credits cut your tax directly.1,2

Learn More

Find personalized help sorting out which senior-care tax breaks your family qualifies for at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.