In most cases, no — you do not file a 1099 for a caregiver. A caregiver you hire directly to work in your home is almost always a household employee under IRS rules, which means the correct form is a W-2, not a 1099-NEC. The 1099-NEC only fits when the caregiver genuinely operates as an independent business, and even then only if you paid them $600 or more during the year.1Internal Revenue Service. Instructions for Forms 1099-MISC and 1099-NEC Getting this call right matters, because issuing a 1099 to someone who should have received a W-2 can leave you owing back payroll taxes, penalties, and interest.
Employee or Contractor: How the IRS Decides
The label you and the caregiver agree to doesn’t control the classification. A signed contract calling someone an independent contractor won’t hold up if the working relationship looks like employment. The IRS looks at three categories of evidence: behavioral control, financial control, and the type of relationship.2Internal Revenue Service. Independent Contractor (Self-Employed) or Employee?
Behavioral control asks whether you direct when, where, and how the work gets done. If you set the schedule, decide which tasks come first, or dictate routines for meals, medication, or bathing, that points to employment. Financial control looks at who bears the business risk. A true contractor buys their own supplies, markets services to multiple clients, and can earn a profit or take a loss. The type of relationship considers whether the work is ongoing, whether you provide benefits, and whether the caregiver’s work is central to your household.
For most in-home caregivers, all of that tilts toward employment. You set the hours, you provide the setting and supplies, and you direct the daily care. The caregiver shows up at one household, follows your instructions, and gets paid. The IRS states plainly that a worker is self-employed only when “only the worker can control how the work is done” and the worker “provides his or her own tools and offers services to the general public as an independent business.”3Internal Revenue Service. Hiring Household Employees
The Narrow Case Where a Caregiver Really Is a Contractor
Some caregiving professionals do run their own businesses. A geriatric care manager who conducts periodic assessments, or a physical therapist who visits on their own schedule using their own equipment, might legitimately be self-employed. They set their methods, they serve multiple clients, and they market to the public. That’s the exception for in-home caregiving, not the rule.
When You Do File a 1099-NEC
If your caregiver truly qualifies as an independent contractor and you paid them $600 or more during the calendar year, you file Form 1099-NEC (Nonemployee Compensation). You send a copy to the caregiver and file with the IRS by January 31 following the year of payment.1Internal Revenue Service. Instructions for Forms 1099-MISC and 1099-NEC
Before you prepare the form, collect a completed Form W-9 from the contractor. The W-9 gives you the legal name, address, and taxpayer identification number that go on the 1099-NEC. If the total you paid for the year is under $600, no 1099-NEC is required. The caregiver still reports the income on their own return; you just have no filing job as the payer.
What Applies Instead: W-2 and Payroll Taxes
If your caregiver is a household employee, the tax picture is different from a 1099 arrangement, and it’s worth knowing what replaces it before you assume the contractor route is simpler.
For 2026, if you pay a household employee $3,000 or more in cash wages during the year, you owe Social Security and Medicare taxes (FICA) on all wages paid to that worker.4Internal Revenue Service. Publication 926 – Household Employer’s Tax Guide The threshold applies per employee. The combined FICA rate is 15.3% of wages, split evenly between employer and employee, though you can choose to absorb the employee’s share instead of withholding it.5Internal Revenue Service. Topic No. 751, Social Security and Medicare Withholding Rates
If you pay total cash wages of $1,000 or more in any calendar quarter of 2025 or 2026 to all household employees combined, you also owe Federal Unemployment Tax (FUTA) on the first $7,000 of each employee’s wages. FUTA is entirely the employer’s cost.4Internal Revenue Service. Publication 926 – Household Employer’s Tax Guide
Federal income tax withholding is not required for household employees. You only withhold it if the caregiver asks you to and you agree, using a Form W-4 and the tables in Publication 15-T. Many caregivers prefer withholding because it prevents a large bill in April.
You report the whole thing on Schedule H, which attaches to your personal Form 1040. There is no separate employer tax return. You furnish the caregiver a Form W-2 and file it with the Social Security Administration along with a Form W-3; for 2026 wages, the W-2 filing deadline is February 1, 2027. You’ll also need an Employer Identification Number before you file anything, which you can request instantly at IRS.gov/EIN or by submitting Form SS-4.6Internal Revenue Service. Instructions for Form SS-4
Payments That Need No Form at All
A few common caregiving arrangements produce no filing job for you.
Caregivers Hired Through an Agency
When you pay a home care agency, the agency is the employer of record. It handles payroll taxes, W-2s, and all employment paperwork for its workers. You’re a client paying for a service. Payments to incorporated businesses (C or S corporations) are also generally exempt from 1099-NEC reporting, and most established agencies are corporations.1Internal Revenue Service. Instructions for Forms 1099-MISC and 1099-NEC
Medicaid Waiver Payments
Caregivers paid through state Medicaid Home and Community-Based Services waiver programs often receive what the IRS treats as “difficulty of care” payments. Under IRS Notice 2014-7, these payments are excludable from gross income under Internal Revenue Code Section 131.7Internal Revenue Service. Notice 2014-7 The state agency administering the program typically handles any reporting. A family member receiving Medicaid waiver funds to care for a relative generally has no W-2 or 1099 obligation running through the person receiving care.8Office of the Law Revision Counsel. 26 U.S. Code 131 – Certain Foster Care Payments
Payments Below the Thresholds
A legitimate contractor paid less than $600 during the year gets no 1099-NEC. A household employee paid less than $3,000 in 2026 cash wages doesn’t trigger FICA or Schedule H.4Internal Revenue Service. Publication 926 – Household Employer’s Tax Guide The caregiver still owes tax on the income; you just have no reporting duty as the payer.
What Misclassification Actually Costs
Issuing a 1099-NEC to a caregiver who should have received a W-2 isn’t a paperwork shortcut. If the IRS reclassifies the worker, you can be held liable for the employee’s unpaid share of FICA taxes, your own unpaid employer share, FUTA taxes, and any income tax that should have been withheld. Penalties and interest run from the original due date. The IRS may also treat the 1099 as an incorrect filing and assess penalties for failing to file the correct form. The math on choosing the “easier” form rarely holds up once that happens.