Think of it this way. If your family’s adjusted income is $50,000, the first $3,750 you spend on medical care is on you. But anything you spend above that $3,750 could be deductible. Given the cost of daily care and therapies for our loved ones, many special needs families meet this threshold much faster than they expect.

Nursing and Therapies Usually Count

The IRS defines medical expenses pretty broadly as the costs of diagnosis, cure, mitigation, treatment, or prevention of disease. Because Skilled Nursing involves a Registered Nurse (RN) or Licensed Practical Nurse (LPN) caring for medical complexities, the IRS typically views this as a fully deductible medical expense.

This often applies to Applied Behavior Analysis (ABA) as well. For families managing Autism Spectrum Disorder or other developmental disabilities, ABA is widely recognized as a medical treatment. If your doctor has prescribed these sessions to help with a specific diagnosis, the cost is generally deductible.

What About Home Health Aides?

This is the question we hear most often. Parents want to know if they can deduct the cost of the aide who helps with daily tasks like bathing, dressing, or eating. The answer is often yes, provided specific criteria are met.

The IRS allows you to deduct personal care services if the individual is considered “chronically ill.” In tax terms, this means a licensed healthcare practitioner has certified that your loved one is unable to perform at least two Activities of Daily Living—like eating, toileting, or dressing—without substantial help for at least 90 days. It also covers supervision required to protect the health and safety of someone with a severe cognitive impairment. If your family member falls into these categories, those hours of care likely count.

The “Hidden” Deductions: Art and Music Therapy

We are so proud of the Art and Music Therapy programs we offer because we see the joy and progress they bring to our clients. You might be surprised to learn that these can be tax-deductible too, but there is a catch.

You must have a Letter of Medical Necessity from a doctor. The doctor needs to state clearly that the therapy is prescribed to treat a specific condition—for example, music therapy to improve fine motor skills related to Cerebral Palsy, or art therapy to address behavioral challenges associated with Autism. If you have that prescription, it’s not just an activity; it’s a medical expense.

Don’t Forget Travel and Home Updates

There are other costs you might be paying without realizing they are deductible. If you have installed ramps, widened doorways, or modified bathrooms to make your home accessible, those costs can often be listed as medical expenses. Even the mileage you drive taking your child to and from their therapy appointments counts. For 2024, the rate is 21 cents per mile, and those trips add up over a full year.

What You Need to Do Now

If you think you qualify, documentation is everything. You will want to have a written prescription or recommendation from a doctor for every service, especially for things like Home Health Aides and Art or Music therapy. Keep a copy of the Plan of Care we use for your family member, as it outlines exactly what services are being provided and why.

And of course, save your invoices. We can help you with that. If you need a copy of your 2024 invoices or need to review your current Plan of Care to ensure it accurately reflects your needs, just give us a call at 305-554-4111.

We aren’t accountants, so please do chat with a tax professional to see how these rules apply to your specific situation. We just want to make sure you aren’t leaving money on the table that could be used to provide even better care for your family.

Helpful Links for further reading:

• IRS Publication 502: Medical and Dental Expenses
• IRS Frequently Asked Questions on Medical Expenses