Key takeaways

• You can deduct medical expenses as extraordinary expenses from your income tax return.
• Medical expenses that are medically required and not covered by the health insurance company qualify for tax purposes. 
• Preventive care medical costs aren’t tax-deductible.
• The tax office reduces the medical costs by a magic number (reasonable burden) for tax purposes. Only the medical expenses exceeding the reasonable burden are tax-deductible.

This is how you do it

• Keep all the medical invoices for the entire calendar year.
• Try to plan expensive medical treatments within the same year.
• Calim all the medical expenses from your tax return.
• You can use tax software to file income tax returns in Germany.  We recommend SteuerGo*, Wundertax*, and Smartsteuer*.

Table of Contents

Can you deduct medical expenses from taxes in Germany?

Yes, you can deduct medical expenses from your income tax return. However, they must exceed the reasonable burden and are not covered by your health insurance.

We will learn what a reasonable burden is later in this guide.

Example: Suppose you incurred medical costs of 3000 € in a calendar year. Your reasonable burden is 2000 €.

In this case, you can deduct the expenses that exceed the reasonable burden from taxes. This is 1000 € (3000 – 2000) in our example.

Prerequisites for medical expenses to qualify for tax purposes

You can deduct the medical expenses from taxes only if you fulfill the following requirements.

• You have the doctor’s prescription or medical need for the treatment.
• Your health insurance doesn’t cover medical costs. Suppose your health insurance covers the cost, but you didn’t submit the expenses for reimbursement. In this case, you cannot deduct the medical bills from taxes.
• You get the treatment from a licensed practitioner.
• You need a medical report from the health officer or your health insurance provider for certain medical treatments. Additionally, the treatment must not be started before the medical report is issued.

What medical costs are tax-deductible in Germany?

The German tax office defines a medical expense as the costs you incur to cure or alleviate an illness. You can claim medical expenses as extraordinary expenses in your income tax return.

You can claim the following medical expenses on your tax return.

Medical treatment

• Medical treatment costs: This includes treatment from a dentist, alternative practitioner, speech therapist, psychologist, or physiotherapist. However, you must have a receipt from a licensed practitioner.

Medicines

• Prescribed medication: You can deduct the cost of medicines a doctor prescribes.
• Preventive medicines: The contraceptive pill is normally not deductible as it falls under the “preventive care” category instead of medically needed. However, if you are medically required to take the pill, you can deduct it from taxes.
• Over-the-counter medication: You can also deduct over-the-counter medication costs as long as they are prescribed by a doctor. 
• Continued use of drugs: People who have long-term illnesses are required to take a drug on a continuous basis. For them, a one-time prescription is enough for tax purposes.
• Medical aids: The tax office considers the costs of only certain medical aids tax deductible. These include glasses, dentures, hearing aids, wheelchairs, etc. For aids like special beds, massage chairs, etc., you need a certificate from a public health officer or the Medical Service of the Health Insurance (MDK).

Travel costs

• Travel costs: You can deduct the cost of travel to a doctor, therapist, hospital, etc.  You can claim the actual travel cost or a flat rate of 0.30 € per kilometer. The tax office limits the cost of travel in your car. It’s limited to the cost you incur by using public transport. However, the limit doesn’t apply if there is no reasonable public transport connection.
• You can even deduct the travel costs to visit a sick relative. However, the visit must have been medically required to improve the relative’s health condition, and you need a certificate from the treating doctor. You can deduct actual travel costs or a flat rate of 0.30 € per kilometer if you travel in your car.
• Overnight accommodation: Suppose your relative must be treated in another city or town. You can deduct the cost of an overnight stay from your tax return.

Traveling abroad

• Travel vaccinations: You can deduct travel vaccinations prescribed by a doctor from taxes.
• Medical treatment costs incurred abroad: Your treatment costs outside Germany are tax-deductible. You can submit your bank or credit card statement as proof. However, a bill from the doctor or hospital is better.

Relatives care

• You can deduct the costs of caring for a relative in a nursing home from taxes. However,the care in the nursing home must be medically required.
• Tips to nursing staff: You can claim the tips to the nursing staff as extraordinary expenses in your tax return. However, the tips must be within reasonable limits. You must specify the individual recipients and the tip amount. Additionally, get a receipt of the tip from the reception.
• Caretaker: Suppose your relative needs the support of a caretaker. You can deduct the caretaker’s costs from your taxes.

Alternate medical treatments

• Alternative treatment methods: This includes acupuncture, oxygen therapy, homeopathy, etc.
• If massages, hot packs, and baths are medically necessary, you can deduct the cost from taxes. You must submit a doctor’s certificate to the tax office as proof. Moreover, the certificate must be issued before the start of treatment.
• Spa and other wellness programs: You can deduct these costs if the treatment can prevent an impending illness. 
• Gym: Your doctor prescribed you training after an injury, such as lower back pain. In this case, you can deduct the costs of gym membership. It’s important that the training is to alleviate the illness and is led by a licensed practitioner. You need a doctor’s certificate and a certificate from the medical officer at the health department as proof.

Sick children

• Costs of accompanying a sick child are tax-deductible. However, you must prove it’s medically necessary. For example, your child broke both legs and is temporarily in a wheelchair.
• School expenses: You can claim school expenses as extraordinary expenses if they are direct medical costs. For example, the costs of school to treat dyslexia, speech therapy, etc.

What medical expenses are not tax deductible in Germany?

You cannot deduct preventive care treatments or medicines from your income tax return. This includes

• Going on a special diet to prevent joint problems in old age
• Vitamins supplements costs
• Nutritional supplements costs
• Dental cleaning expenses
• Contraceptive pills, etc.

How do you deduct medical expenses from your income tax return?

• Keep all the medical bills from pharmacies, opticians, audiologists, or other healthcare providers. Small sums add up to big amounts. Many pharmacies in Germany offer to keep an account for their customers and prepare an annual statement. You can use it when filing your income tax return.
• Note the travel expenses you incurred for medical reasons, like visiting a doctor, accompanying your child to the doctor, etc.
• Claim all the medical expenses you incurred during the calendar year. The tax software and the tax office will determine if the expenses exceed the reasonable burden.

TIP: If possible, plan expensive medical treatments in the same calendar year. This increases the probability of exceeding the reasonable burden.

What is a reasonable burden?

A reasonable burden is the amount calculated by the tax office. The tax office uses this sum to reduce your extraordinary expenses for tax purposes.

The reasonable burden depends on your income, marital status, and number of children. 

The idea behind reasonable burden is that one can afford certain expenses and doesn’t need government support.

So, the more you earn, the more you can afford. Hence, your reasonable burden will be more.

How does the German tax office calculate a reasonable burden?

The reasonable burden is a percentage of your GdE income.

What is the percentage?

The tax office has divided the income into three groups and given a percentage based on income group, marital status, and the number of children.

The table below shows what percentage is considered when calculating a reasonable burden.

	Income up to €15,340	Income from €15,340 to €51,130	Income over €51,130
Without children
Basic tariff / single	5%	6%	7%
Splitting tariff / married	4%	5%	6%
With children
One or two children	2%	3%	4%
Three or more children	1%	1%	2%

GdE income

The tax authorities consider GdE income to calculate a reasonable burden. GdE income is gross income minus income-related expenses, the age relief amount, the allowance for farmers and foresters, and the allowance for single parents ( Section 2 EStG ).

For example, suppose you are single with no child and earn 50k € gross per annum. You don’t get any of the above-mentioned allowances.

You can deduct the flat rate for income-related expenses of 1230 € (tax year 2023) from your gross income. Thus, your GdE income is 48,770 € (50k-1230).

In this case, your reasonable burden is 6% of 48,770k, i.e., 2926.2 €.

Suppose your medical expense was 4000 €. The tax office will deduct the reasonable burden, i.e., 2926.2, from the medical costs to get the tax-deductible amount.

Hence, you can deduct 1074 € (4k – 2926 €) from taxes.

You can also use the tax office calculator to calculate the tax-deductible amount.