Many times family members or friends provide care to a loved one for a fee. These family members or friends are typically unlicensed caregivers. Can the person paying for the care deduct the payments as a medical expense on their income tax return?
Medical expenses, not compensated for by insurance or otherwise, may be allowed as a deduction to the extent that the expenses exceed 7.5% of the taxpayer’s adjusted gross income. Medical care can include amounts paid for “qualified long-term care services” as defined herein. The taxpayer must be certified as “chronically ill” by a licensed health care professional. The services must be provided pursuant to a plan of care prescribed by a licensed health care professional.
The U.S. Tax Court recently ruled on the issue of whether payments to unlicensed care providers were deductible. Estate of Lillian Baral v. Commissioner of Internal Revenue (July 5, 2011).
The tax court examined whether payments totaling $49,580 made by Lillian to Ms. Pzevorski and Ms. Jakubowski were deductible. Neither of them were licensed healthcare providers. Thus, the payments were not deductible as medical expenses. However, the court found that payments to them could be deducted if their services qualified as “long-term care services” as defined under the tax code.
After analyzing the tax code, the Court found that the care provided constituted “maintenance or personal care services” for a “chronically ill individual” provided pursuant to a “plan of care prescribed by a licensed health care professional.” Thus, Lillian could deduct $43,273 of the payments made to the care providers (the amount paid which exceeded 7.5% of her adjusted gross income).
For Medicaid purposes the payments will be considered gratuitous when provided by a family member, unless there is a written contract. It is advisable that there be a written contract providing for reasonable compensation and specifying the nature of services to be provided.
Kim Boyer, CELA
BOYER LAW GROUP




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