What can I declare as convalescence costs in the tax return?
Expenses incurred for a convalescence treatment or rehabilitation measure can be entered in your tax return as extraordinary burdens. However, the expenses must be medically necessary. For this, you need a public health officer's certificate. If the Medical Service of your health insurance company has already checked the necessity and the treatment is co-financed by the insurance company, an additional certificate is not required. The certificate or check must be issued before the start of the treatment.
The treatment must be carried out under medical supervision. An exception is a climate treatment, where a positive effect is achieved through the favourable climate, and no supervising doctor is required.
A prerequisite for a children's treatment is usually the accommodation of the child in a children's home.
You can deduct all health-related expenses that are not reimbursed by the health insurance as treatment costs.
Treatment costs may include:
- Doctor's fees,
- Fees for medical certificates or attestations,
- Medications or other remedies,
- Baths or other treatments,
- Local spa tax,
- Travel to and from the location, and
- Accommodation and meals.
However, meal costs are not fully recognised and must be reduced by a so-called household saving of 20 percent.
For the accompanying person of a child undergoing treatment, travel and accommodation costs can also be deducted, as well as for a helpless elderly person. However, the doctor must certify the necessity of the accompaniment. For a severely disabled person with a registered need for accompaniment in their ID, an additional certificate is not required.
As travel expenses for the journey to and from the location, only the costs for public transport are generally recognised. To have the costs for travelling by private car recognised, you must prove that travel by bus or train was unreasonable for health reasons, for example, due to mobility issues.
The certificate must contain sufficiently specific information about the spa location in accordance with § 64 para. 1 sentence 1 no. 2a EStDV. The statement "in a tropical climate" alone is not sufficient to determine the spa location. The certificate must show that the taxpayer is ill and that a stay at a specific spa location is medically indicated for a certain period. The public health officer must specify in their statement where exactly a climate treatment is medically indicated due to the existing illnesses (FG Münster, judgement of 23.2.2022, 7 K 2261/20 E).
(2023): What can I declare as convalescence costs in the tax return?
How must I provide evidence of the costs for a health treatment?
You must provide evidence of the expenses for your convalescence or rehabilitation treatment. The tax office also requires you to prove the medical necessity of the treatment. For this, you need a medical certificate from the public health officer or the approval for cost coverage from the Medical Service of the Health Insurance. It is important that the certificate is issued before you start the treatment.
Once you have a certificate from the public health officer recommending a specific measure or medication, collect the receipts, even for other medical expenses. Only at the end of the year will it be clear how much you have actually spent on treatments, remedies, or therapies. The treatment costs are combined with expenses for other general extraordinary burdens such as medical expenses, divorce costs, or funeral costs.
You can deduct from tax, without limit, any amount exceeding your reasonable personal burden. Depending on income, marital status, and number of children, the reasonable personal burden is between one and seven percent of the total income.
You can use our overview to determine whether it is worthwhile to include an entry in the tax return, as the tax office automatically deducts your reasonable burden from the actual expenses. Only the remaining amount has a tax-reducing effect.
The certificate must contain sufficiently specific information about the spa location in accordance with § 64 para. 1 sentence 1 no. 2a EStDV. The statement "in a tropical climate" alone is not sufficient to determine the spa location. The certificate must show that the taxpayer is ill and that a stay at a specific spa location is medically indicated for a certain period. The public health officer must specify in their statement where exactly a climate treatment is medically indicated due to the existing illnesses (FG Münster, judgement of 23.2.2022, 7 K 2261/20 E).
(2023): How must I provide evidence of the costs for a health treatment?
