Some aging-in-place care can be paid pre-tax
Most families don't realize how much aging-in-place care can run pre-tax. Physical therapy, medical equipment, and hearing aids qualify as medical care under IRS §213(d). Companion care at home is held to a higher bar — IRS §7702B(c) long-term-care rules, where a physician certifies chronic illness and writes a plan of care. Here's your annual savings picture.
Custodial companion care is held to a higher bar than diagnosis-tied items. It can qualify only under IRS §7702B(c) long-term-care rules: a physician certifies the person is chronically ill — needing help with 2+ daily activities expected to last 90+ days, or living with severe cognitive impairment — and writes a plan of care. At a 22% bracket, $4,800/yr in care is roughly $1,056 in tax savings — illustrative, and only once a physician certifies and your plan administrator approves HSA/FSA use. Not guaranteed; not tax advice.
Start the physician evaluation for companion careco-op.care places companion caregivers who earn $26/hr W-2 plus equity — which means the same caregiver stays with your family. Caregiver-owned cooperatives run roughly 24–38% turnover versus roughly 75% industry-wide — a third to half the churn of agency care.
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