Is Assisted Living Tax Deductible? What IRS Publication 502 Says

The federal rules on deducting medical costs are explained in IRS Publication 502, Medical and Dental Expenses. The edition on the IRS website in October 2026 is the 2025 edition, written for 2025 returns. The IRS issues a new edition each year, so check the edition for the year you are filing.

Publication 502 does not have a section called assisted living. Its index sends readers who look up assisted living homes to the section headed Nursing Home, and its Long-Term Care section covers people who are chronically ill. Those two sections are described below in plain terms. This page describes what the IRS publishes. It is not tax advice.

Publication 502 (2025) says medical and dental expenses are deducted on Schedule A of Form 1040, and only the part that is more than 7.5% of adjusted gross income. IRS Topic 502 says the same thing: the deduction is available to people who itemize, to the extent the expenses exceed 7.5% of adjusted gross income.

Two more limits apply. Topic 502 says the deduction covers only expenses not compensated by insurance or otherwise. Publication 502 says total medical expenses for the year must be reduced by all reimbursements received from insurance or other sources. Money paid back by a long-term care policy is a question to raise with the tax preparer for that reason.

The Nursing Home section of Publication 502 (2025) covers the cost of medical care in a nursing home, home for the aged, or similar institution, for the taxpayer, a spouse or a dependent. It draws one line:

The Long-Term Care section of Publication 502 (2025) says amounts paid for qualified long-term care services can be included in medical expenses. It defines those services as necessary diagnostic, preventive, therapeutic, curing, treating, mitigating and rehabilitative services, and maintenance and personal care services, that meet two conditions: they are required by a chronically ill individual, and they are provided under a plan of care prescribed by a licensed health care practitioner.

The publication says a person is chronically ill if, within the previous 12 months, a licensed health care practitioner has certified that the person meets either of these descriptions:

• The person is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. The activities are eating, toileting, transferring, bathing, dressing and continence.
• The person requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

Publication 502 describes maintenance or personal care services as care whose primary purpose is giving a chronically ill individual needed assistance with their disabilities, including protection from threats to health and safety due to severe cognitive impairment. Help with bathing, dressing and supervision is what many residents of assisted living and memory care receive.

Whether a particular resident's costs qualify, and how much of the bill, turns on facts the IRS rules name: the certification, the plan of care, the reason for living in the home, and what the charges are for. A home's own care assessment sets its care level and fee. It is a separate document from a practitioner's certification, so do not assume one stands in for the other.

Two smaller points from the same publication. A qualified long-term care insurance premium can be included up to a limit that depends on age: for 2025, $4,810 for a person age 61 to 70 and $6,020 for a person age 71 or over. Our guide to long-term care insurance in assisted living covers how those policies pay. And part of a life-care fee paid to a retirement home under a lifetime care agreement can be included, if it is properly allocable to medical care and the home provides a statement.

Publication 502 (2025) says a taxpayer can generally include medical expenses paid for themselves, a spouse, or a person who was a dependent when the services were provided or when the bill was paid. A parent can be a dependent as a qualifying relative, which has a support test.

The publication also lets a taxpayer include medical expenses paid for a person who would have been a dependent except that the person had gross income of $5,200 or more in 2025 or filed a joint return. When siblings share a parent's support under a multiple support agreement, it says only the sibling treated as providing more than half the support can include the medical expenses that sibling actually paid.

Who pays, and from whose account, can change the result. Our guide for families paying for a parent's assisted living covers sharing costs. Ask a tax professional before setting up the payments.

Good records make the tax preparer's job possible. These are the things to gather and ask:

1. 1

   Keep every monthly statement

   California law requires an RCFE admission agreement to say that the resident will receive a monthly statement itemizing all separate charges. See the admission agreement guide for what else it must contain.

2. 2

   Ask the home how its bill is broken down

   Ask whether it can show room and board separately from care charges, and whether it gives residents a year-end summary. Homes differ, and none is required to give tax advice.

3. 3

   Ask the doctor about certification

   Ask whether a licensed health care practitioner has certified, within the previous 12 months, that your parent meets the chronically ill definition, and whether there is a prescribed plan of care.

4. 4

   List every reimbursement

   Long-term care insurance payments and any other reimbursements for the year, since Publication 502 requires them to be subtracted.

5. 5

   Take it all to a tax professional

   Ask which costs can be included, whose return they belong on, and whether itemizing makes sense for that year.

Hamssa Benrekia is a senior living placement specialist in Torrance who works with families in the South Bay and Harbor area of Los Angeles County. She does not give tax advice and cannot say what is deductible. She can help you compare licensed assisted living communities and board and care homes, and ask each one how its monthly bill is itemized. More money topics are in the California Assisted Living Placement Guide. To talk about homes, contact Hamssa.