How are excesses in health insurance taken into account for tax purposes?

Individuals with private health insurance often pay medical bills up to a certain amount out of their own pocket to preserve the premium refund, which can often amount to up to six months' premiums. Although the premium refund reduces the deductible insurance premiums for the special expenses deduction, resulting in a lower tax saving.

However, many believe this disadvantage can be offset by claiming the self-borne medical expenses as extraordinary expenses according to § 33 EStG, thereby achieving a corresponding tax saving.

Medical expenses borne by the individual due to a tariff-based deductible or the choice of a premium refund are not "contributions" to health insurance and therefore cannot be deducted as special expenses (BMF letter dated 19.8.2013, BStBl. 2013 I p. 1087, para. 69). The BFH has also confirmed that self-borne costs in the event of illness do not constitute insurance contributions and cannot be deducted as special expenses.

These are not "contributions" to health insurance. Rather, they are medical expenses and can only be claimed as extraordinary expenses according to § 33 EStG (BFH ruling of 1.6.2016, X R 43/14).