While Medicare does not cover the cost of long-term care services, they may qualify as a deductible medical expense. Since your spouse is chronically ill and requires personal care services, the cost is deductible provided they are pursuant to a plan of care prescribed by a licensed health care practitioner. As children in school are told: Get a doctor’s note.
A nondeductible contributory IRA that allows for tax-free accumulation of income. Qualifying distributions are completely tax free.