By Naomi Foster · Health Writer, Senior Care CostsUpdated 2026-07-09
By Naomi Foster · Health Writer, Senior Care CostsAssisted living is expensive, and many families want to know whether any of it comes back at tax time. Some of it can, as a medical expense, but the rules are specific. Here is what determines whether the cost qualifies.
The IRS allows you to deduct qualified medical expenses that exceed 7.5% of your adjusted gross income, if you itemize. Assisted living costs can count as medical expenses, but generally only the portion tied to medical care or personal care for a chronically ill resident, not the room and board by itself. The details are laid out in IRS Publication 502.
If a resident is chronically ill, meaning a licensed professional has certified that they need help with at least two activities of daily living, such as bathing, dressing, or eating, or they need supervision due to cognitive impairment, and the care is provided under a plan of care, then a larger share of the cost can qualify as a medical expense. In some cases that includes room and board when the primary reason for being in the facility is to receive medical care.
If a resident is in assisted living mainly for housing and convenience rather than medical need, only the clearly medical services, such as nursing help or medication management, are deductible. The rent and meal portion is treated as a personal living expense and does not count. The facility can usually break out the medical share for you, which is the figure you would use.
You can deduct qualifying medical costs you pay for yourself, a spouse, or a dependent. A parent may count as a dependent for this purpose even if they do not live with you, provided you cover more than half of their support and other tests are met. That means an adult child paying for a parent's care may be able to claim the medical portion, which surprises many families.
Hold on to the itemized statements that separate care from room and board, the plan of care, and the professional certification of chronic illness if one applies. The IRS does not want these with your return, but you need them if asked. A tax professional can confirm how much of a specific bill qualifies. You can estimate the underlying cost in the assisted living cost calculator.
One detail decides whether any of this helps: you can only deduct qualified medical expenses above 7.5% of your adjusted gross income, and only if you itemize. For a resident with high care costs relative to their income, that threshold is easy to clear, and the deduction can be meaningful. For someone with modest costs and higher income, it may not reach far enough to matter. Run the numbers for the specific year.
Sometimes, and only in part. If you itemize deductions, you can count qualified medical expenses that go over 7.5% of your adjusted gross income, and assisted living can supply some of that total. When a resident is chronically ill and receiving care under a documented plan of care, a bigger share of the bill, potentially including room and board, can qualify as a medical expense rather than just ordinary housing.
In most cases, only the medical and personal-care services count, not the rent and meals. That changes if the resident is chronically ill and the facility is following a written plan of care, because then room and board can be pulled into the deductible total too. If someone is in assisted living mainly for convenience rather than medical need, only the clearly medical line items on the bill, like nursing visits or medication management, are eligible.
It is possible if you are paying more than half of your parent's support and they meet the IRS dependency tests, even when they live somewhere else entirely. In that case you may be able to deduct the qualifying medical share of what you pay toward their care, on top of any medical expenses of your own. Because the support test has specific rules, it is worth having a tax professional check your situation before you file.
Hang onto the itemized billing statements that break out medical and personal care from room and board, along with the written plan of care and any professional certification of chronic illness. None of that goes with your tax return when you file, but you need to have it ready if the IRS asks questions later. A tax professional can also help confirm which line items on a specific bill actually qualify.
Naomi researches how IRS medical-expense rules apply to senior care costs, translating the fine print into plain language without standing in for a CPA or tax preparer.