Are costs for dietary meals for coeliac disease tax deductible?

Under current legislation, additional costs for a gluten-free diet due to coeliac disease cannot be claimed as extraordinary expenses for tax purposes. This was decided by the Federal Fiscal Court (BFH) in 2021. Even if the diet replaces medical treatment, tax deductibility remains excluded. According to Section 33, Paragraph 2, Sentence 3 of the Income Tax Act, costs for dietary food, as required for coeliac disease, are not considered extraordinary expenses, as they replace regular food items needed by all taxpayers (BFH decision of 4.11.2021, VI R 48/18).

Current status of the constitutional complaint

A constitutional complaint has been filed against this ruling (Ref. 2 BvR 1554/23). The Federal Constitutional Court is currently examining whether the current regulations of the Income Tax Act are constitutional. A possible decision could affect many taxpayers with medically necessary diets.

Other open questions regarding medical expenses

In addition to the question of the deductibility of dietary costs, the reduction of medical expenses by the reasonable personal contribution is also being discussed. In another case (Ref. 2 BvR 1579/22), the Federal Constitutional Court is examining whether the current practice of the personal contribution is lawful, after the BFH deemed this reduction permissible in a 2021 ruling (BFH decision of 1.9.2021, VI R 18/19).

Conclusion: Currently, the additional costs for dietary food due to coeliac disease are not deductible. However, affected taxpayers can hope for a decision from the Federal Constitutional Court, which may reassess the deductibility.