Assisted living costs can count toward the medical expense deduction, in part or in full. IRS Publication 502 is the IRS guide to medical costs. It counts meals and lodging in a home for the aged or similar institution when a principal reason for being there is medical care. It also counts qualified long-term care services for a chronically ill person. You can deduct only the part above 7.5% of adjusted gross income, and only if you itemize.
Key facts
- IRS Publication 502 counts meals and lodging in a home for the aged or similar institution as medical expenses when a principal reason for being there is to get medical care. (IRS, 2025)
- Only the part of total medical and dental expenses above 7.5% of adjusted gross income is deductible, as an itemized deduction on Schedule A (Form 1040). (IRS, 2025)
- Qualified long-term care services count for a chronically ill person only if a licensed health care practitioner certified the condition within the previous 12 months and the care follows a prescribed plan of care. (IRS, 2025)
- You can include medical expenses you paid for a parent who would have been your dependent except for having gross income of $5,200 or more in 2025 or filing a joint return. (IRS, 2025)
- For 2025, the limit on qualified long-term care insurance premiums that count as medical expenses is $4,810 per person for ages 61 to 70 and $6,020 for ages 71 and older. (IRS, 2025)
Assisted living can cost tens of thousands of dollars a year. So it's natural to ask whether any of it comes back at tax time. That could be on your parent's return, or on yours if you're paying. The answer depends on your parent's health, the reason for the move, who pays, and the rest of the tax return. This post explains what the IRS rules say and which records make a deduction possible. It also lists the questions to bring to a tax professional, who makes the actual call.
The rules and dollar figures in this post come from IRS Publication 502 for 2025 returns. Publication 502 for 2020 had the same 7.5% of AGI threshold and the same rules on meals and lodging and on qualified long-term care services. A 2020 law, Public Law 116-260, made the 7.5% threshold permanent for tax years after 2020. Some dollar figures change every year, though. For 2020, the gross income figure in the dependent rule was $4,300 instead of $5,200. The long-term care premium limits were $4,350 for ages 61 to 70 and $5,430 for 71 and older.
What IRS Publication 502 says about assisted living costs
Publication 502 doesn't use the words "assisted living." So you have to read two of its sections together.
Nursing Home. You can include in medical expenses the cost of medical care in a nursing home, home for the aged, or similar institution. That includes meals and lodging if a principal reason for being there is to get medical care. If the reason for being there is personal, you can include only the part of the cost that is for medical or nursing care. The meals and lodging don't count then.
Long-Term Care. You can include amounts paid for qualified long-term care services. These include personal care services, meaning help with daily activities. A chronically ill person must need them. They must also be provided under a plan of care prescribed by a licensed health care practitioner.
Put together, the rules lead to different outcomes depending on the situation:
| Situation | What Publication 502 lets you include | What decides it |
|---|---|---|
| A principal reason for being there is medical care | The cost of care, including meals and lodging | Your parent's condition and why they moved; documentation from a practitioner |
| Chronically ill, with a plan of care | Qualified long-term care services, including personal care | Certification within the last 12 months and a prescribed plan of care |
| The move was mainly personal (convenience, company, no longer wanting to keep a house) | Only the part of the cost for medical or nursing care | How the community breaks down its charges |
Is your parent's community a "similar institution"? And what share of the bill qualifies? A tax professional should judge that with your records in front of them.
The "chronically ill" test and the plan of care
Publication 502 has a set definition of a chronically ill individual. A licensed health care practitioner must have certified, within the previous 12 months, that the person meets one of these tests:
- They can't perform at least two activities of daily living without substantial help from another person. This must be true for at least 90 days, due to a loss of functional capacity. The activities of daily living are eating, toileting, transferring, bathing, dressing and continence.
- They need substantial supervision to be protected from threats to health and safety because of severe cognitive impairment.
Two practical points follow. First, the certification has a clock: "within the previous 12 months." Ask your parent's doctor about it at the yearly visit, well before taxes are due. Second, services must follow a plan of care prescribed by a licensed practitioner. The community may write its own service or care plan. If it does, ask your tax professional whether you'll need that plan, the doctor's orders, or both.
Publication 502 also says a qualified long-term care insurance contract covers only qualified long-term care services. So if your parent is claiming on such a policy, the paperwork often overlaps. See using long-term care insurance for assisted living.
The 7.5% of AGI rule and itemizing
Even qualifying expenses aren't fully deductible. You claim them on Schedule A (Form 1040), and only in part. Publication 502 says you can deduct only the part of total medical and dental expenses that is more than 7.5% of adjusted gross income (AGI).
A hypothetical example: your dad's AGI is $40,000. 7.5% of that is $3,000. Say his qualifying medical expenses for the year total $50,000, and that includes the qualifying part of his assisted living bill. Then the amount above the threshold is $47,000. That figure then competes with the standard deduction. Itemizing only helps when total itemized deductions are larger.
Other items in Publication 502 can add to the total. These include prescribed medicines, doctor and dental bills, and insurance premiums for medical care. A limited amount of qualified long-term care insurance premiums counts too. For 2025, the premium limit per person is $4,810 for ages 61 to 70 and $6,020 for 71 and older.
Who can claim the expenses, your parent or you?
Publication 502 says you can generally include medical expenses you pay for yourself, your spouse or your dependent. If your parent pays from their own money, the expense goes on their return. If you pay, you can include the expenses only if your parent was your dependent for this purpose. That has to be true either when the services were provided or when you paid.
Publication 502 relaxes the usual dependent test for medical expenses. You can include medical expenses you paid for a person who would have been your dependent except for one of two things. They had gross income of $5,200 or more in 2025, or they filed a joint return. For a parent, the key test is usually support. You must have provided over half of their total support for the year.
When siblings share the cost. Maybe no one of you pays more than half, but together you do. Then a multiple support agreement can let one of you treat the parent as a dependent. In Publication 502's example, four siblings each provide a quarter of a parent's support. Under the agreement, one of them treats the parent as a dependent. No one can count the medical expenses paid by the others in the agreement. The sibling who claims can include what they paid themselves and weren't repaid for. Talk it through with a tax professional early in the year, and write it down. Splitting caregiving costs with siblings covers the family conversation.
Records to start keeping on move-in day
Any deduction rests on the paperwork. So start a folder, paper or digital, with these records:
- Monthly statements from the community that separate charges for personal care, nursing or medication services from rent and meals.
- The practitioner's certification of chronic illness, with its date.
- The plan of care and the community's service plan.
- Proof of who paid each bill, from which account.
- Pharmacy, doctor, dental, hearing aid and equipment receipts.
- Insurance reimbursements received. These reduce the amount you can deduct.
- Any multiple support agreement between siblings.
A request to make of the business office each year: "For tax purposes, could you give us a year-end statement? Please show what we paid for personal care, nursing or medication services separately from rent and meals. And can you tell me which licensed staff provide the care?"
If several family members pay, a single log of who paid what saves arguments later. Tracking caregiving expenses as a family shows a simple setup.
One costs log for the whole family
Parent Move Plan includes a shared costs log. The family's receipts go in one place you can hand to a tax professional. The move itself runs on a day-by-day plan counted back from move-in.
Get your first 3 days freeQuestions to ask a tax professional
Bring the folder above and ask:
- Does my parent's community count as a "home for the aged or similar institution" under Publication 502?
- Given my parent's condition, is medical care a principal reason for being there? If so, can meals and lodging count too?
- Does my parent meet the chronically ill definition? Is our certification dated correctly?
- Which document serves as the plan of care?
- Should the expenses go on my parent's return or mine? Do I meet the support test?
- If my siblings and I share costs, should we use a multiple support agreement? Who should claim?
- After the 7.5% threshold, does itemizing beat the standard deduction this year?
- How do long-term care insurance benefits or reimbursements change the amount?
- If the house is sold this year, how does that affect the rest of the return?
The IRS says anyone with a Preparer Tax Identification Number can prepare returns for pay. But credentials vary. CPAs, enrolled agents and attorneys have recognized credentials, and the IRS publishes a directory of preparers with credentials. If your parent is 60 or older, the IRS Tax Counseling for the Elderly program offers free help. Much of it comes through AARP Foundation's Tax-Aide sites.
Taxes are one part of the money picture. For the rest, see how families pay for assisted living.
Frequently asked questions
Can I deduct my mother's assisted living costs on my taxes?
Possibly, if you paid them and she qualifies as your dependent for the medical expense deduction, which generally means you provided more than half of her support. IRS Publication 502 lets you include her medical expenses even if her own gross income was $5,200 or more in 2025. A tax professional can check the details.
Are meals and rent in assisted living deductible?
IRS Publication 502 says meals and lodging in a home for the aged or similar institution count as medical expenses if a principal reason for being there is to get medical care. If the reason is personal, only the part of the cost for medical or nursing care counts.
What counts as chronically ill for the tax deduction?
Under Publication 502, a licensed health care practitioner must have certified within the previous 12 months that the person can't perform at least two activities of daily living without substantial help for at least 90 days, or needs substantial supervision because of severe cognitive impairment.
Do we have to itemize to deduct assisted living costs?
Yes. The medical expense deduction is an itemized deduction on Schedule A (Form 1040), and only the part of total medical expenses above 7.5% of adjusted gross income is deductible. Whether itemizing beats the standard deduction depends on the whole return.
Are assisted living costs tax deductible for past tax years?
They can be, under the rules for that year. IRS Publication 502 for 2020 had the same 7.5% of AGI threshold and the same rule on meals and lodging as the 2025 edition, though dollar figures such as the dependent gross income limit change each year. If you didn't claim a deductible medical expense in an earlier year, Publication 502 says you can file Form 1040-X to claim a refund for that year and not claim it on this year's return. Generally, the claim must be filed within 3 years from the date the original return was filed or within 2 years from the time the tax was paid, whichever is later.
What assisted living expenses are tax deductible?
Under IRS Publication 502, qualified long-term care services, including help with daily activities, count for a chronically ill person whose care follows a plan of care prescribed by a licensed health care practitioner. Meals and lodging count too if a principal reason for being in the community is to get medical care. If the move was mainly personal, only the part of the bill for medical or nursing care counts, so statements that separate those charges from rent and meals matter.
Sources
- IRS: Publication 502 (2025), Medical and Dental Expenses (accessed Sept 2026)
- IRS: Choosing a tax professional (accessed Sept 2026)
- IRS: Free tax return preparation for qualifying taxpayers (accessed Sept 2026)
- IRS: Publication 502 (2020), Medical and Dental Expenses (accessed Oct 2026)
- Legal Information Institute: 26 U.S. Code section 213, Medical, dental, etc., expenses, with notes on the 2020 amendment by Pub. L. 116-260 (2020) (accessed Oct 2026)