Care-Plan IRS language for chronically ill person
Executive summary
A compliant IRS care-plan for a “chronically ill individual” must document that a licensed health care practitioner has certified the person as chronically ill, show that the care is primarily for maintenance or personal care because of that condition, and prescribe a written plan describing required services, timeframes and supervising provider — elements the IRS uses to determine whether expenses or benefits qualify as medical or tax‑favored long‑term care (see Pub. 502 and FLTCIP guidance) [1] [2]. Below is a practical, IRS‑focused template and explanation tying each sentence to the IRS rules and related reporting forms (Form 1099‑LTC, Form 8853) and recent tax updates that affect long‑term care funding [3] [4] [5].
1. What the IRS requires in plain language
The IRS treats a “chronically ill individual” as someone certified by a licensed health care practitioner within the prior 12 months who either needs substantial assistance with activities of daily living (ADLs) or requires substantial supervision because of severe cognitive impairment; maintenance and personal care services must have as their primary purpose providing needed assistance for that disability (Pub. 502; FLTCIP) [1] [2]. The certification and a written plan of care are central to qualifying expenses as medical or to showing eligibility for tax‑favored long‑term care benefits under section 7702B and related guidance [3] [2].
2. Minimal elements the IRS expects in a written care plan
The plan must identify the certifying licensed practitioner, state the clinical diagnosis or functional basis for chronic illness, document which ADLs are impaired (e.g., bathing, dressing — IRS examples reflected in policy guidance), state the extent and frequency of assistance required, list specific maintenance/personal care services to be provided, estimate the expected duration, and bear the practitioner’s signature and date certifying medical necessity — each element maps to the IRS focus on certification, prescribed services, and primary purpose of care (Pub. 502; FLTCIP) [1] [2].
3. Sample IRS‑oriented care‑plan language (editable template)
“Patient: [Name]; Date of certification: [date]. I, [licensed practitioner name, license number, state], certify that [Name] is a chronically ill individual as defined by IRS guidance. Clinical basis: [diagnosis and brief functional findings]. Functional limitations: unable to perform without substantial assistance the following ADLs: [list at least two ADLs], or requires substantial supervision due to severe cognitive impairment. Prescribed primary maintenance/personal care services: [e.g., assistance with bathing daily; feeding x/day; medication management; skilled nursing visits x/week]. Anticipated duration of need: [estimated months/years or ‘ongoing’]. Plan objective: maintain safety, prevent deterioration, and provide daily care. Provider signature and date: [signature].” The content reflects the IRS requirement for practitioner certification, the ADL or cognitive threshold, and a prescribed plan of care tied to medical necessity [1] [2].
4. Why precise language matters for taxes and benefits
Accurate wording matters because tax treatments and reporting hinge on the certification and plan: qualified LTC contracts and accelerated death benefits exclude income to the extent they align with IRS definitions, and Form 1099‑LTC and Form 8853 require that payments relate to periods when the insured was chronically ill (Form 1099‑LTC instructions; Form 8853 instructions) [3] [4]. For taxpayers considering alternatives, recent 2026 changes let some use qualified retirement funds penalty‑free for qualified LTC insurance purchases up to IRS limits — a separate but relevant planning tool to fund care once the person meets the IRS chronic‑ill standard [5].
5. Limits of available reporting and practical next steps
The cited IRS publications and insurer program guidance set the definitional and reporting framework but do not prescribe a single mandated sentence; rather, they require the elements described above (Pub. 502; FLTCIP; Forms 1099‑LTC and 8853) [1] [2] [3] [4]. For implementation, practitioners and families should have the licensed certifier complete and sign a written plan containing the elements above, retain contemporaneous clinical notes, and consult the insurance contract and tax forms referenced when preparing returns or responding to issuer reporting [3] [4].