ComfortCard
Is the care covered?

Check in two minutes — and hear an honest no if that's the answer.

This asks about the person and the help they need, not about a purchase. That's the difference that matters: the tax code treats certain long-term care as medical care already — it was never something a letter turns on.

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Question 1 of up to 4
Who is the care for?
HSA and FSA funds can only be used for you, a spouse, or a tax dependent. This decides more cases than anything else, so we ask it first.
Last question
Who will actually be providing the care?
This one surprises people, so we ask it plainly. The law treats care differently depending on who delivers it — not just who needs it.
Question 2 of up to 4
Do they qualify as your tax dependent?
Generally this means you provide more than half of their support and can claim them under IRS §152. If you're not sure, "no / not sure" is the safer answer here.
Question 3 of up to 4
Which of these need real hands-on help from another person?
Not "would be easier with help" — genuinely cannot be done safely alone. Check all that apply.
Last question
Has this lasted — or is it expected to last — at least 90 days?
The standard is about lasting need, not a short recovery.
One more
Can they be left alone safely?
Sometimes someone can still do the daily tasks but can't be left unsupervised — memory loss that means the stove is left on, or walking out and not finding the way back. This is a real, separate standard, not a workaround.

Based on what you told us, this looks like covered care.

What you've described fits qualified long-term care — which the tax code already treats as medical care, not something a letter converts. That's the solid ground.

The real next step isn't a form. Certification needs an actual encounter — a visit, in person or by video, with the practitioner who signs, and a plan of care that matches the help you described. There is no letter without that. It's what makes the documentation hold up years later.

See how certification works →

Honestly — this doesn't meet the standard yet.

We'd rather tell you now than write something that fails later. Based on your answers, the care here doesn't meet the test for qualified long-term care.

That doesn't mean the care isn't real or isn't worth paying for — only that it isn't treated as a medical expense under these rules today. If the situation changes and the need becomes lasting, the answer can change with it.

See other ways ComfortCard helps →

HSA funds probably can't cover this person.

Pre-tax accounts can only be spent on you, a spouse, or someone who qualifies as your tax dependent. If a parent or another adult isn't your dependent, the account can't be used for their care — no matter how real the need is.

This is worth confirming with whoever prepares your taxes before you spend anything. It's the question that most often decides whether any of this works, which is exactly why it's the first one we ask.

Care can still be arranged and paid for — and other programs may pay or support you even when the HSA can't. It simply isn't a pre-tax expense in this case.

See what you qualify for →

The need qualifies. The payment wouldn't.

Everything you described meets the standard for a chronically ill individual. But the tax code looks at who delivers the care as well as who needs it — and care provided by a spouse or relative is specifically treated as not a medical expense, even when the need is real and the work is constant.

This is §213(d)(11). It excludes care given by a spouse, child, sibling, parent, grandparent, aunt, uncle, niece, nephew or in-law — and it closes the obvious workaround, so routing the same work through a company the family owns doesn't change it. The one exception is a family member who is a licensed nurse or aide providing care within that licence.

We'd rather tell you now than take a fee and have it disallowed later. Two things are still true: the care is real, and there are programs that will pay or support you for it — the VA, Medicaid self-direction, paid leave, and a credentialed-caregiver path that changes this answer. A two-minute scan finds the ones that fit.

See what you qualify for →
The rule we work from

A letter cannot make a personal expense medical. It can document care that already is.

In March 2024 the IRS issued an alert about companies that misrepresent wellness and general-health spending as medical care. It was explicit that notes based on self-reported information don't convert personal spending into medical care, and that real documentation requires a visit with the treating provider. We agree with that, and we built to it.

Where the ground is solid is long-term care. Qualified long-term care services are already medical care under §213(d)(1)(C) by way of §7702B(c) — when the person is chronically ill and the services follow a plan of care prescribed by a licensed practitioner. Nothing is being converted. The certification is what the law asks for. Read the full standard →

General information, not tax or legal advice. Eligibility depends on IRS rules, your plan's terms, and your circumstances. This check runs entirely in your browser and stores nothing.