Working in One State & Living in Another: A Tax Guide for Healthcare Professionals

Working in One State & Living in Another: A Tax Guide for Healthcare Professionals

In an increasingly interconnected world, more healthcare professionals find themselves navigating the complexities of working in one state while living in another. This common scenario raises important tax considerations that can affect your financial planning and legal obligations. Whether you’re commuting across state lines for work, telecommuting for a company in another state, or considering a job offer that would have you working remotely for an out-of-state employer, understanding the tax implications is crucial. This guide aims to demystify the tax rules, provide clarity on residency requirements, and offer practical advice for managing your tax responsibilities efficiently.

Understanding Your Tax Obligations

Between patient care and other work-related responsibilities, navigating tax complexities can be overwhelming. Here are some things you need to understand regarding your tax responsibilities as a medical professional who is working in one state while living in another.

Residency & Tax Liability

Tax liability is primarily determined by your residency status. Most states consider you a resident if you maintain a permanent home in the state or spend a significant amount of time there, typically more than 183 days a year. As a resident, you’re usually required to pay state income tax on all your income, regardless of where it’s earned. This means that your total income from all sources, including wages, dividends, and interest from out-of-state investments, is subject to taxation in your home state.

Working Across State Lines

If you work in a state different from where you live, you may have to file tax returns in both states. Generally, the state where you work will want to tax the income earned there, while your home state will also tax your global income, leading to potential double taxation. This situation requires careful tax planning to avoid paying more than necessary.

Reciprocal Agreements

Some neighboring states have reciprocal agreements that simplify tax matters for cross-border workers. These agreements allow residents of one state to request exemption from income tax withholding in the other state, meaning they only file and pay income taxes in their state of residence. For instance, if you live in Pennsylvania but work in New Jersey, Pennsylvania’s agreement with New Jersey means you only owe state income tax to Pennsylvania. It’s important to notify your employer if such an agreement exists to ensure correct tax withholding.

Non-Reciprocal States: Navigating Multiple Tax Returns

In the absence of a reciprocal agreement, you’ll likely need to file non-resident tax returns in the state where you work and resident returns where you live:

  • File a Non-Resident Tax Return: Declare the income earned in the work state.
  • File a Resident Tax Return: Report all income, both domestic and international, to your home state. Typically, you’ll receive a credit for taxes paid to other states.

As an example, suppose you live in Illinois and work in Indiana, two states without a reciprocal tax agreement. Here are the steps you would follow:

  • Withhold Indiana state income tax on your earnings.
  • File a non-resident return in Indiana to report the income earned.
  • File a resident return in Illinois, reporting your total income and claiming a credit for taxes paid to Indiana.

Special Considerations

When working in one state and living in another, you may also need to take other considerations into account that can impact your filing.


For telecommuters, tax implications can depend on company policies and state laws. Some states tax telecommuting income based on the employer’s location, others on the employee’s residence. Check with your employer before filing.

Military Spouses

Military spouses may retain a legal residence for tax purposes in one state even if they move frequently. The Military Spouses Residency Relief Act allows them to only pay income taxes to their state of legal residence.

Tips for Managing Taxes Across States

  • Understand State Laws: Each state’s tax code is unique. Understanding both the laws of your resident state and your employment state is crucial.
  • Maintain Accurate Records: Keep detailed records of your income and where it was earned to simplify filing and support any claims.
  • Consult a Tax Professional: Navigating multi-state taxation can be complex. A tax professional can offer tailored advice and ensure you meet all your tax obligations.

Planning for the Future: Strategic Tax Moves

Being proactive in your tax strategy can save you significant money and stress. Here are additional tips:

  • Adjust Your W-4: Modify your withholding allowances to ensure the right amount is being withheld, especially if you anticipate a refund.
  • Make Estimated Payments: If your withholding doesn’t cover your tax liability, consider making estimated tax payments to avoid penalties.
  • Utilize Tax Deductions and Credits: Understand which deductions and credits are available in both your work and home states to minimize liabilities.
  • Consider Relocating: If tax burdens are high, it might be worth considering a move, especially if your job allows for remote working arrangements.

The Bottom Line: Mastering Your Tax Strategy Across State Lines

Navigating the tax landscape when you live in one state and work in another doesn’t have to be a daunting task. With the right knowledge and strategies, doctors and healthcare workers can manage tax obligations effectively and avoid common pitfalls that lead to overpayment or penalties. By staying informed about tax laws, consulting with tax professionals, and planning ahead, you can ensure that you are complying with tax regulations while optimizing your financial situation.

The information provided in this blog post is for general informational purposes only and should not be construed as financial advice. For specific financial counsel on filing taxes, we strongly recommend seeking the guidance of a qualified expert.

Published on Apr 17, 2024

Written by The Influent Staff

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