How Siblings Split the Cost of Home Care in Massachusetts

Start by dividing an actual monthly number, not a vague commitment to help. Home health aide care is $45 an hour, so three hours a day is about $4,095 a month, which is $1,365 each across three siblings. There is one tax rule that decides whether any of you can deduct a dollar of it, and most families get it wrong by accident.

What are we actually dividing?

Pick the schedule first, then split the figure. At $45 an hour on a 30 day month:

• Three hours twice weekly: about $1,170 a month. Split three ways, $390 each.
• Two hours a day: about $2,730. Split three ways, $910 each.
• Three hours a day: about $4,095. Split three ways, $1,365 each.
• Four hours a day: about $5,460. Split three ways, $1,820 each.
• Six hours a day: about $8,200. Eight hours a day: about $10,900.
• Overnight, $540 for a twelve hour night. Every night runs about $16,200 a month, or $5,400 each across three.
• Around the clock, $1,080 a day, about $32,800 a month. Split three ways that is just under $11,000 each, every month.

We publish these rates, which means you can do this arithmetic on a family phone call tonight without waiting for anyone to quote you. There is no minimum contract, no assessment fee and no four hour minimum per visit, so you can start at two visits a week and add hours when the money or the need changes.

Meals, laundry and light housekeeping are part of an aide visit. These are the hours families usually buy first.

Should we split it evenly?

Even thirds is the simplest answer and the one most families land on, but it ignores the sibling who lives nearby. That person is usually absorbing the pharmacy runs, the phone calls from the hospital, the Saturday afternoons and the unpaid hours nobody invoices. Two common adjustments: the local sibling pays a smaller share, or the local sibling's share is covered first so that paid hours relieve the days they are carrying. Decide it out loud and write it down. The arrangements that blow up are the ones nobody ever said plainly.

Who should the bill go to?

One payer, with the others reimbursing that person, is the cleanest arrangement to run and the one that keeps the tax question answerable. Three people each paying a third of every invoice creates a reconciliation problem every month and, as the next section explains, can wipe out the deduction entirely. Call us at 781 957 8076 and tell us how the family wants billing set up before the first visit rather than after.

Can we deduct the cost, and can each of us deduct our share?

This is the rule to get right, and it is counterintuitive. Under IRS Publication 502, you can include medical expenses you paid for a parent who is your dependent. A parent can also qualify even if they are not your dependent, when the only thing disqualifying them is that their gross income was too high, which was $5,200 or more for 2025, or that they filed a joint return.

The part families miss is the multiple support agreement. When several children together provide more than half of a parent's support but no single one provides over half, they can sign an agreement letting one of them claim the parent. Publication 502 then says that medical expenses paid by the others who joined the agreement cannot be included by anyone. Not by them, and not by the one claiming the parent. Only the unreimbursed amount the claiming sibling paid themselves counts. Its own example is four siblings each providing a quarter of support, where the one who paid the medical bills and was reimbursed for three quarters can include only the quarter they actually bore.

The practical consequence: if three of you each send a third of the invoice straight to the agency, you may collectively end up deducting nothing. Decide deliberately who claims the parent, route the care payments through that person, and have the others support the parent in other ways. Two more details worth knowing. Medical expenses only count above 7.5 percent of adjusted gross income, so a modest amount of care may not clear the floor at all. And where an attendant also does household tasks, Publication 502 requires you to split their pay between the medical and nonmedical portions, so keep the visit notes.

We are a home care agency, not accountants. These figures come from Publication 502 for 2025 returns and the thresholds change year to year, so take the actual filing decision to your own accountant or attorney before you commit to who pays what.

Is there a cheaper or free route we should exhaust first?

Yes, and you should check all of these before any sibling writes a check:

• Call the Aging Services Access Point for your parent's town. State funded home care is income based and may cover some or all of the hours.
• If your parent has MassHealth, ask about the personal care attendant program. Our referrals go to pcm@careremedy.com.
• Check the town Council on Aging for meals, rides and a free wellness check, which can shrink the number of paid hours you need.
• Look for a long term care policy in your parent's paperwork. Many families have one and never file.
• If your parent has a Medicare Advantage plan, read the supplemental benefits. Some include a limited number of in home hours.

What if one sibling cannot pay?

Buy fewer hours rather than overcommitting and canceling in month three. Because there is no minimum contract, three hours twice weekly at about $1,170 a month is a legitimate starting point, and it is far better for your parent than a bigger plan that collapses. A sibling who cannot contribute money can take the overnight stays, the weekend coverage or the appointment transport, which has real dollar value against the care plan.

How do we know the aide actually showed up?

That question matters more when three people are paying and only one lives nearby. We log visits in MyCase, our own coordination platform, so a missed shift is visible rather than something you find out about a week later. Our aides are trained, background checked and insured, and they are not nurses. They do not administer medication, including insulin, do not change dressings and do not make clinical judgments. Nursing is a separate service, priced separately.

Related reading: home care costs per hour and per month in Massachusetts, hiring a caregiver for just a few hours a day, and how to make a long term care policy actually pay for a home aide.

How do we start?

Agree on a weekly schedule and a split, then call 781 957 8076 or email info@careremedyinc.com. We serve eastern and western Massachusetts from offices in Woburn, Springfield and Brockton. Nothing on this page is tax or legal advice, so confirm the filing questions with your own accountant and the benefit questions with the program itself.