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Taxes, Cash & Savings · Surprise rank #2

Paid to Care Through a Medicaid Home-Care Program? Those Wages Can Be Tax-Free

Some qualifying Medicaid home- and community-based waiver caregiver payments can be excluded from federal taxable income under IRS Notice 2014-7.

Who

Caregivers receiving qualifying Medicaid waiver payments for care provided to an eligible person who lives in the caregiver's home.

What to do

Start here: Compare your exact payment arrangement with the IRS Notice 2014-7 guidance and keep documentation of the qualifying Medicaid waiver payments.

Eligibility: The payment and living arrangement must meet IRS Notice 2014-7 conditions; not every Medicaid or home-care payment qualifies.

What you get

Qualifying Medicaid HCBS waiver caregiver payments may be excluded from federal gross income.

Benefit: Federal income-tax exclusion on qualifying caregiver payments.

Possible value: Varies with the amount of qualifying caregiver pay and the caregiver's tax situation.

Good to know

Important: The exclusion applies to qualifying Medicaid waiver/difficulty-of-care payments for care provided in the caregiver's own home where the care recipient lives. It does not automatically cover every home-care payment, and federal income-tax treatment can differ from FICA treatment.

Availability: Active

Why people miss it: These payments can look like ordinary taxable caregiver wages even when special federal tax treatment applies.

Sources reviewed: Aug 10, 2026