IRS Notice 2014-7

Difficulty of Care
Exclusion

There's a real IRS rule that may let some paid caregivers keep more of what they earn.

If you're paid through a Medicaid Home & Community-Based Services (HCBS) waiver program to provide care to someone who lives with you, those payments may be excludable from your federal taxable income under IRS Notice 2014-7.

In plain English: if you qualify, some (or sometimes all) of those waiver payments may not count as taxable income for federal income tax purposes.

A Few Quick Clarifications

(Because this gets misunderstood a lot)

  • It's not about who owns the home. The key is that you and the person receiving care live together in the same home (whether they moved in with you OR you moved in with them).
  • It doesn't matter whether you're related or not. The IRS guidance applies either way.
  • It's specific to certain Medicaid waiver payments. Not every caregiver payment qualifies.

What to Do Next

This page is general informationโ€”not tax advice. The safest next step is to read the IRS guidance and review it with your accountant or tax preparer to confirm whether it applies to your exact situation.

How Silver Home Care Can Help

We work with family caregivers in Bucks and Philadelphia Counties who provide care through Medicaid waiver programs.

If you're already caring for a family member at home, we can help you get set up with Community Health Choices so you can get paid for what you're already doingโ€”and potentially keep more of it thanks to the Difficulty of Care Exclusion.

If you're thinking about becoming a caregiver for a loved one, we can walk you through the process and make sure everything is set up correctly from the start.

We handle the paperwork, enrollment, and ongoing documentation. You focus on your family.

Want to Learn More?

Whether you're already caregiving or just exploring your options, we're happy to answer questions and explain how it all works.