How to Get Mileage Reimbursement for Caregivers

Caregiver mileage reimbursement is a system for repaying caregivers for the costs of using their personal vehicle for work-related duties. This process helps offset expenses like gas and vehicle wear and tear incurred while providing care. It covers transportation costs directly associated with the care recipient’s needs.

Determining Eligibility for Reimbursement

A primary factor in eligibility is the nature of the travel. “Qualified travel” involves transporting the care recipient for appointments and errands. This includes trips to doctors’ offices, pharmacies, physical therapy sessions, and grocery stores.

Not all driving is eligible for reimbursement. The most common example of “non-qualified travel” is the caregiver’s commute. The miles driven from the caregiver’s home to the care recipient’s residence and back are not covered, as this is considered a standard commuting expense, similar to any other job.

The caregiver’s role also influences eligibility. An individual employed by a home care agency is subject to the company’s reimbursement policies. A family member providing care might find eligibility through a government program with its own set of rules. The specific arrangement defines the pathway to reimbursement.

Sources of Mileage Reimbursement

Medicaid is a source for caregiver mileage reimbursement, but its programs vary significantly by state. Reimbursement is often available through state-administered Home and Community-Based Services (HCBS) waiver programs. These waivers allow individuals to receive care in their homes, and since each state designs its own program, the rules for mileage reimbursement differ.

The Department of Veterans Affairs (VA) offers programs that may cover transportation costs. The Beneficiary Travel Program can reimburse caregivers for mileage when accompanying a veteran to VA-approved medical appointments. Another option is the Veteran Directed Care (VDC) program, which gives veterans a budget to manage their care, and this can be used for mileage reimbursement as part of a spending plan. To qualify, a caregiver might need to be formally recognized under the National Caregiver Program or be deemed a medically required attendant.

Long-term care insurance policies may be a source, but coverage depends on the specific contract. Some policies list transportation or mileage as a covered expense. Review the policy documents, looking at the schedule of benefits and covered services, or contact the insurance provider to confirm if mileage is a reimbursable expense.

When a caregiver is hired directly by a family, mileage reimbursement is a matter of private agreement. It is best to have a formal, written care agreement in place before services begin. This document should outline all terms of employment, including a section on mileage that states the reimbursement rate and the process for submitting mileage for payment.

Required Documentation and Record-Keeping

To receive reimbursement, accurate record-keeping is required. The primary documentation is a detailed mileage log, which serves as evidence for any claim. This log must be maintained contemporaneously, meaning each trip is recorded as it occurs.

Each entry in the mileage log must contain specific data points to be complete. These details are used to calculate the reimbursement and ensure every mile claimed is tied to a qualified caregiving activity. A complete log includes:

• The date of each trip.
• The starting and ending locations with specific addresses.
• The purpose of the trip, such as “transport to Dr. Smith’s appointment.”
• The starting and ending odometer reading for each trip to calculate total miles.

This process of logging each trip provides the proof required by programs like Medicaid, the VA, or private employers. Without a detailed log, claims can be delayed or denied.

Tax Considerations for Caregivers

The tax treatment of mileage reimbursement depends on the payment plan. When a caregiver is reimbursed under an IRS “accountable plan,” the money received is not taxable income. Most formal reimbursement programs from agencies or government entities are set up as accountable plans. This requires that travel expenses are work-related and substantiated with a detailed mileage log. If the reimbursement rate is at or below the standard IRS business rate, the payments are not reported as wages.

If a caregiver is not reimbursed for travel expenses, they may be able to claim a tax deduction for miles driven for medical purposes. This is claimed as a medical expense on Schedule A of Form 1040, which requires itemizing deductions instead of taking the standard deduction.

To claim this deduction, the total of all medical expenses, including mileage costs, must exceed 7.5% of the taxpayer’s Adjusted Gross Income (AGI). Only the amount above this threshold is deductible. The IRS sets a specific mileage rate for medical travel, which is 21 cents per mile for 2025 and can differ from the standard business rate.