Who can claim medical expenses as exceptional costs?
Anyone who can provide evidence of medical expenses can also declare them in their tax return. You will need a receipt, an invoice and, in some cases, a medical certificate. It does not matter whether you incur the expense for your own illness, for your spouse's illness, or for a child for whom you are entitled to child benefit. What counts is the date you paid the invoice, not the date it was due.
Wegeunfall
If you have medical expenses related to a commuting accident or a work accident, you should declare them as income-related expenses or business expenses. This also applies to costs incurred due to an occupational illness or retraining due to illness. The advantage is that in this case a reasonable burden is not applied.
(2021): Who can claim medical expenses as exceptional costs?
What are medical aids?
Aids are intended to compensate for limitations caused by illness or disability. Particular emphasis is placed on supporting the development of children and preventing impending care needs.
Medical aids include, for example:
- Hearing and visual aids,
- Orientation, mobility or reading aids,
- Wheelchairs (or walking aids),
- Prostheses, orthopaedic stockings, etc.,
- Blood pressure and blood sugar monitors, as well as
- other similar aids needed in individual cases.
(2021): What are medical aids?
What medical expenses can I deduct?
As medical expenses, you can deduct all costs incurred in connection with an illness. You can enter these as extraordinary expenses in your tax return without limit.
The tax office automatically deducts the reasonable deductible, which depends on your income, marital status, and number of children. This deductible ranges from one to seven percent of your annual income and is taken into account for all general extraordinary expenses, including medical expenses.
Expenses you can claim as medical costs include:
- medical treatment
- health spas, physiotherapy, etc.
- care services
- alternative practitioners or homeopaths
- medication
- pharmacy co-payments
- medical aids
- hospital stays
- travel to the doctor, hospital, physiotherapy, etc.
Travel expenses: If you travel to the doctor by public transport, you can deduct the actual costs incurred, so keep the tickets. However, if you travel by car, you can deduct a flat rate of 0.30 Euro per kilometre.
You can also claim the costs for dental prostheses or a cure. However, not the expenses for visiting a sick person or measures to prevent illness, such as a diet or a back massage for relaxation.
Tipp
For health courses aimed at fitness or weight reduction that are not prescribed by a doctor, you should try to obtain a credit from your health insurance company through a bonus booklet. Many statutory health insurance companies offer this – ask your health insurance company directly.
Conversely, you must also deduct reimbursements or co-payments from the health insurance, pension, or accident insurance from your expenses before entering them in the tax return. However, you do not have to have payments from daily sickness allowance insurance credited.
An exception applies to certain bonus payments from your statutory health insurance. This means: If costs for health measures are reimbursed by the statutory health insurance as part of a bonus programme to promote health-conscious behaviour (according to § 65a SGB V) that are not included in the regular insurance coverage and have therefore been privately financed in advance by the insured, this reimbursement is a benefit from the health insurance and not a premium refund. The health insurance contributions deductible as special expenses are therefore not to be reduced by the amount of the reimbursement. Such a benefit from the health insurance only exists in cases where, according to the specific bonus model conditions, the insured person must have incurred costs for additional health measures in advance, which are then reimbursed on the basis of proof of costs ((BMF letter dated 06.12.2016, IV C 3 - S 2221/12/10008; BFH ruling dated 01.06.2016, X R 17/15).
Lohnsteuer kompakt
Currently, the Federal Fiscal Court has ruled that bonus payments from private health insurance "to promote cost-conscious behaviour" are to be regarded as premium refunds and therefore reduce the deductible special expenses if the bonuses are paid regardless of whether the policyholder has incurred financial health expenses or not (BFH ruling dated 16.12.2020, X R 31/19).
(2021): What medical expenses can I deduct?
How do I provide evidence of medical expenses?
You must provide evidence of expenses for medication, remedies, and other medical costs with receipts. The tax office also requires proof that the medication or treatment is medically necessary. For this, you usually need a doctor's prescription. If you have a chronic illness, it is generally sufficient to present the medical certificate once. If your ophthalmologist has prescribed glasses for you once, confirmation from the optician is sufficient for the necessity of expenses for further glasses.
Tip
As soon as you have a medical certificate from your doctor recommending a specific measure or medication, collect the receipts. Only at the end of the year will you know the total amount of your expenses for remedies and treatments. Medical costs, together with expenses for other general extraordinary burdens, form a total. You can then use our overview to calculate whether it is worthwhile to include them in your tax return, as the tax office deducts your reasonable personal contribution from the actual expenses. Only the amount exceeding the reasonable burden has a tax-reducing effect.
In certain cases, the medical necessity must be proven by a certificate from the public health officer or a statement from the Medical Service of the Health Insurance Funds. It is important that this proof is obtained before the start of the treatment or before purchasing the medical remedy. This strict proof is required in the following cases:
- Bath or spa treatment; for a preventive spa treatment, the risk of an illness to be prevented by the treatment, for a climate spa treatment, the medically indicated spa location and the expected duration of the treatment must also be certified,
- psychotherapeutic treatment,
- medically necessary external accommodation of a child of the taxpayer suffering from dyslexia or another disability,
- necessity of care for the taxpayer by an accompanying person, unless this is already evident from the severely disabled person's pass,
- medical aids considered to be general everyday items,
- scientifically unrecognised treatment methods, such as fresh and dry cell treatments, oxygen, chelation, and autologous blood therapy.
(2021): How do I provide evidence of medical expenses?
