Paying for home care in Ontario: tax credits and coverage

Most families do not pay for private home care from one pot. They use a mix: the public plan for what it covers, savings or family contributions for the rest, and tax credits to get some of it back later. This guide walks through the main options in Ontario, in plain language. It is general information, not tax or legal advice, so confirm your own situation with the Canada Revenue Agency (CRA) or an accountant.

Start with what the province already pays for

If your parent qualifies, Ontario Health atHome arranges publicly funded home care, such as personal support, nursing and therapy. A care coordinator sets the hours based on an assessment of need. If the plan is not enough, you can ask for a reassessment, and then decide whether to add private hours. The full picture is in private home care or Ontario Health atHome?

The federal medical expense tax credit

The CRA allows amounts paid for attendant care to be claimed as medical expenses. Here is what its guide says, in short:

• An attendant does personal tasks that a person cannot do for themselves.
• The attendant must have been 18 or older when paid, and cannot be your spouse or common-law partner.
• If you pay an individual attendant, the receipt needs their social insurance number.
• A full-time attendant at home needs either an approved Disability Tax Credit certificate (Form T2201) or a written certification from a medical practitioner that you need a full-time attendant because of an impairment.
• You or your spouse can claim amounts paid for yourself, your spouse, or a dependant. A dependant can include a parent or grandparent who lived in Canada and depended on you for support.
• You can choose any 12-month period ending in the tax year, as long as the expenses were not claimed before.
• For a full-time attendant at home, you can claim either the disability amount or the expenses, but not both. The CRA suggests working out your tax both ways to see which is better.

Ontario Seniors Care at Home Tax Credit

The Government of Ontario describes this as a refundable credit for lower and moderate income seniors aged 70 or older. It gives back 25% of eligible medical expenses, on up to $6,000 of expenses, for a maximum credit of $1,500. The credit shrinks by 5% of family net income above $35,000. Qualifying expenses include wheelchairs, hospital beds, dental, vision and hearing care, and attendant care, which requires certification.

Other places money may come from

These depend entirely on the person, so they are worth asking about rather than assuming:

• Workplace or private health plans. Some extended health plans cover home care or nursing. Read the plan, or ask the insurer.
• Auto insurance. If the care is needed after a car accident, ask the insurer about attendant care benefits.
• Family contributions. Some families agree on a monthly split between siblings. A short family meeting early on can prevent a lot of stress later.

Questions to ask before you spend

1. Does my parent qualify for more public hours? Ask for a reassessment first.
2. Will the doctor sign the certification for attendant care, and how long does it take?
3. Does the agency give itemized receipts that match what the CRA asks for?
4. What is the minimum visit length, and is there a charge for cancelling?
5. Who is the employer? An agency usually handles payroll and deductions. If you hire someone directly, you may become the employer, so ask an accountant first.

If you would like to talk it through, a free in-home care assessment is a good place to start, and our coordinators can explain what a plan would involve before you commit to anything.

Questions families ask

Sources

• Canada Revenue Agency: Medical Expenses (RC4065)
• Government of Ontario: Seniors Care at Home Tax Credit fact sheet
• Government of Ontario: Home and community care