What medical expenses can I deduct?

Medical expenses can be deducted without limit as extraordinary expenses in the tax return. However, the tax office deducts a reasonable personal contribution, which ranges from 1% to 7% of annual income, depending on income, marital status, and number of children. Reimbursements from health insurance or other insurance must be deducted from the expenses.

Deductible medical expenses:

• Medical treatment
• Spa treatments, physiotherapy
• Care services
• Alternative practitioners or homeopaths
• Medications and pharmacy co-payments
• Medical aids
• Hospital stays
• Travel expenses to doctor, hospital, physiotherapy, etc.

Travel expenses:

• Public transport: Actual costs can be deducted; tickets should be kept.
• Own car: A flat rate of 0.30 Euro per kilometre can be claimed.

Costs for dental prostheses or a medically prescribed cure are also deductible. Not deductible are expenses for hospital visits or preventive measures such as diets or massages for relaxation.

Bonus programmes and reimbursements

Many statutory health insurance companies offer bonus programmes under § 65a SGB V for health-conscious behaviour. These bonus payments do not reduce the special expenses deduction for health insurance contributions, as they do not constitute premium refunds (BFH ruling of 1.6.2016, X R 17/15; BFH ruling of 6.5.2020, X R 16/18).

Examples include premiums for preventive medical check-ups, vaccinations, or sporting activities. Bonuses for family-insured members are credited to the main insured person.

Distinction from premium refunds (BMF letter of 16.12.2021)

• Premium refunds reduce the special expenses deduction, e.g. premiums under § 53 SGB V for participation in general practitioner-centred care.
• Bonus payments for measures outside basic health insurance cover, such as osteopathy or gym memberships, are not considered refunds and do not reduce the special expenses deduction.

Tips:

1. Bonus payments up to 150 Euro per person do not reduce the special expenses deduction. If the bonus exceeds this amount, the excess must be counted as a premium refund.
2. Check the tax assessment notice: Sometimes bonus programmes are not reported correctly by the health insurance company. Therefore, check the values applied.
3. Private health insurance: Bonus payments from private health insurance to promote cost-conscious behaviour reduce the special expenses deduction if they are paid regardless of financial expenditure incurred.