Almost every other medical expense in Ireland gets tax relief at the standard 20% rate. Nursing home fees are one of the few that qualify at your marginal rate — which means up to 40% back if any of your income is taxed at the higher rate. For a family paying a typical private Fair Deal contribution, that can be four-figure savings every year — but Revenue doesn't refund it automatically. You have to claim it.
Why nursing home fees get the higher rate
The tax code treats nursing home care as a "health expense" that's deducted from your total income — not given as a tax credit. Because deductions reduce your taxable income, you get relief at whatever rate that income would otherwise be taxed. If any of it would have been taxed at 40%, your relief on that slice is 40%.
Standard medical expenses (GP visits, physio, dental) use a flat 20% tax credit instead, regardless of your tax band. Nursing home fees are the exception — and for most families paying them, it's a meaningful difference.
The rules in plain English
What qualifies
- Fees paid to a nursing home that provides 24-hour on-site nursing care. The 24-hour nursing requirement is strict — a residential facility without qualified nursing cover doesn't qualify at this rate.
- Additional qualified-nurse home-nursing expenses (at home, on medical advice, from a registered nurse).
- Fees for a spouse, parent, child, or any dependent relative — not just your own.
What doesn't qualify (or only partially)
- The HSE's portion of Fair Deal: you can only claim on the amount you actually pay yourself, not what the HSE pays on your behalf.
- Short stays without 24-hour nursing cover.
- Fees already reimbursed by private health insurance.
- "Hotel" extras the home charges separately — hairdressing, newspaper delivery, social programmes — unless they're bundled into the nursing fee itself.
The Fair Deal loan — a special case
If part of the cost is paid under the Nursing Home Loan (Ancillary State Support), you can't claim relief while the HSE is paying that asset contribution. But when the loan is repaid — usually by the estate after death, or by the resident if they leave care — the repaid amount can be claimed as a health expense by the person (or the estate) who settles the loan. In practice this often happens as a one-off claim in the tax year of repayment.
How much you can actually claim back
The formula is:
Your fee paid personally × your top tax rate = tax relief
Some worked examples, using 2025 income tax bands:
Example 1 — full 40% relief
A daughter pays €30,000 a year in private nursing home fees for her father. She's on PAYE, earning €60,000, so a chunk of her income is in the 40% band. The €30,000 fee deduction reduces her taxable income by €30,000 — with much of that reduction hitting the 40% band. Relief: approximately €12,000 a year.
Example 2 — partial 40%, partial 20%
A couple pays €15,000 a year in fees. Their combined income is €55,000, so only part of their income is at the 40% rate. The relief would be roughly €4,500–€6,000 depending on the exact split between the two bands.
Example 3 — 20% relief only
A pensioner pays €8,000 a year out of her own pocket (the rest is HSE-paid under Fair Deal). Her income is all in the standard rate band. Relief: €1,600. Still worth claiming — but not at the marginal rate.
Who claims?
The person who pays the nursing home fee is the one who claims the relief — not necessarily the resident. If three adult children split the cost, each claims their share on their own return.
The resident can claim on their own behalf if they're paying out of their own income/savings and still file a return.
How to claim via Revenue myAccount
Here's the step-by-step for PAYE workers using Revenue's myAccount portal:
- Sign in to revenue.ie → myAccount.
- Select "Review your tax 2020–2024" (or the current year).
- Pick the tax year you want to claim for.
- Choose "Statement of Liability" — this opens the tax return form.
- In the return, go to "Tax Credits & Reliefs" → "Health" → "Nursing Homes".
- Enter the total you paid in that tax year (your contribution only, not the HSE's).
- Submit the return. A revised Statement of Liability shows your refund.
Self-assessed taxpayers claim the same deduction on the Form 11 annual return (Health expenses → Nursing home).
You can backdate up to 4 years
Revenue lets you claim health-expense relief for the current year plus the previous 4 tax years. That means in 2026 you can still claim for 2022, 2023, 2024 and 2025 — important if nobody has been claiming for a parent's nursing home fees up to now.
Records to keep
Revenue may ask for documents. Keep:
- Annual fee statements from the nursing home (most provide one for tax purposes in January)
- Bank statements or direct debit records showing the payments
- If you're claiming for a dependent relative, proof of the relationship isn't usually requested but is worth having on file
- If insurance reimbursed any of the cost, the insurance claim paperwork
If you're not the main earner
If you're on a low income and can't absorb the full deduction, the unused portion can't be carried forward or transferred to a spouse. For tax-efficient planning in a family where costs are shared, it's often best for the highest-rate taxpayer to formally pay the fees (so the relief hits at 40%), then settle up with siblings privately.
What to do next
- Gather last year's fee statement and sign in to myAccount tonight — the claim takes ~15 minutes.
- If you're a sibling splitting cost with others, agree who will be the payer of record for the coming year.
- Read our Fair Deal guide to understand what portion of the fee is your contribution (claimable) vs HSE (not claimable).
Sources: Revenue — Nursing home and additional nursing care expenses, Citizens Information — Tax relief on nursing home fees. General information, not tax advice. Talk to a tax adviser for complex cases.