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 the 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
- Health spas, physiotherapy
- Care services
- Alternative practitioners or homeopaths
- Medications and pharmacy co-payments
- Medical aids
- Hospital stays
- Travel expenses to doctors, hospitals, 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 applied.
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 01.06.2016, X R 17/15; BFH ruling of 06.05.2020, X R 16/18).
Examples include premiums for preventive medical check-ups, vaccinations, or sporting activities. Bonuses for family-insured members are attributed to the main insured person.
- 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 coverage, such as osteopathy or gym memberships, are not considered refunds and do not reduce the special expenses deduction.
Tips:
- 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.
- Check the tax assessment notice: Sometimes bonus programmes are not reported correctly by the health insurance company. Therefore, check the values applied.
- 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.
Health insurance bonus payments from 2025
From 01.01.2025, bonus payments up to 150 Euro annually (under § 65a SGB V) do not reduce the special expenses deduction.
Only the exceeding amount is considered a premium refund and must be applied to the special expenses.
It is possible to provide evidence that the additional amount was not a refund but paid for health measures (§ 10 para. 2b EStG).
