Deduct Medical Expenses From Taxes In Germany [2026 Guide]

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.
• Claim all the medical expenses from your tax return.
• You can use tax software to file income tax returns in Germany.  We recommend Wundertax*, SteuerGo*, and Smartsteuer*.
• We recommend consulting a tax advisor for complex tax returns. You can get a free quote a tax advisor here. The tax consultant offer services in English.

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.

What is a reasonable burden? ->

Example: Suppose you incurred medical costs of 3000 € in a calendar year. Your reasonable burden is 2000 €. You can deduct the expenses that exceed the reasonable burden from taxes, i.e., 1000 € (3000 – 2000).

Prerequisites for medical expenses to qualify for tax purposes

You can deduct the medical costs 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 (Az 2 V 1883/11, Az 9 K 325/16).
• You get the treatment from a licensed practitioner.

Requirements for special treatments, such as spa services, psychotherapeutic treatments, or non-scientifically recognized treatment methods, such as fresh cell therapy.

• A doctor’s certificate alone may not be sufficient. You need a medical certificate from a public health officer (amtsärztliches Gutachten) or from the MDK (ärztliche Bescheinigung des MDK) (§ 64 EStDV).
• Treatment must not be initiated until the medical certificate is issued.

NOTE: For most cases, a doctor’s certificate is enough to prove the medical necessity of your expenses (Az. VI R 27/13).

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 on your income tax return.

List of extraordinary expenses that are tax-deductible ->

NOTE: You can only claim the expenses that are not reimbursed by your health insurer.

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.
• You can deduct the costs of artificial insemination on your tax return (Az. III R 47/05).

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 being medically needed. However, if you are medically required to take the pill, you can deduct it from taxes – for example, in cases of menstrual irregularities, hormonal acne, or hereditary diseases like schizophrenia.
• 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 continuously. 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 such as special beds and massage chairs, 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 via 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 deduct the travel costs to visit a sick relative. However, the visit must have been medically required to improve the relative’s health condition. You also need a certificate from the treating doctor to prove the medical requirement of your visit. 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 vaccination costs from taxes. You must meet the following requirements.
  • The doctor prescribed the vaccination.
  • You received the vaccination before your travel.
  • Your health insurance didn’t or partially cover the costs.
• 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 necessary.
• Tips to nursing staff: You can claim the tips for the nursing staff as extraordinary expenses on 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 for 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: You can deduct the costs of alternative treatment methods, such as 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 is intended to 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. A licensed practitioner must lead the training to alleviate the illness. You need a doctor’s certificate and a medical certificate from a public health officer (amtsärztliches Gutachten) 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.

NOTE: You should collect and submit all the medical expenses when filing the tax return. Even if the tax office rejects it, you have nothing to loose.

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
• Vitamin supplements cost
• Nutritional supplements cost
• Dental cleaning expenses
• Contraceptive pills for birth control, 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.
• Record 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 costs exceed the reasonable burden.
• Suppose the medical expenses alone are not enough to exceed the reasonable burden. There are other extraordinary expenses that you can add on top to exceed the limit.

How do you calculate the reasonable burden amount? ->

We find WISO Steuer* (German), SteuerGo*, Check24 Tax (German), and Wundertax*, among the best tax software out there. Here is the complete comparison of the tax software in Germany.

If you have a complex tax return, or filing it yourself makes you nervous, you should get advice from a tax advisor.

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%

What is a 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 ).

List of income-related expenses you can deduct from taxes in Germany ->

List of tax allowances you get in Germany ->

Example

Suppose you are single with no children and earn 50k € gross annually. You don’t get any of the above-mentioned allowances.

You can deduct the flat rate for income-related expenses, which is 1230€ (as of 2025) from your gross income. Thus, your GdE income is 48,770 € (50k-1230).

	GdE income	48,770€ (50,000 – 1230)
Reasonable burden	5 % of income share up to 15,340€	767 € (5% of 15430)
	6 % of income share over 15,340€ to 51,130€ (48,770 – 15,340)	2,005.80€ (6% of 33,430)
	Total reasonable burden (rounded)	2,772 € (767 + 2005.8)

Suppose your medical expense was 4000 €. The tax office will deduct the reasonable burden, i.e., 2772€ from the medical costs to get the tax-deductible amount.

Hence, you can deduct 1228 € (4k – 2772 €) from taxes.

You can also use the tax office calculator to calculate your reasonable burden and the tax-deductible amount.

References

• https://www.finanztip.de/krankheitskosten/
• https://www.haufe.de/finance/haufe-finance-office-premium/lohnsteuerermaessigungsverfahren-2020-426-aussergewoehnliche-belastungen_idesk_PI20354_HI9235523.html
• https://lstn.niedersachsen.de/steuer/steuerberechnungen/zumutbare-belastung-33-abs-3-estg-67672.html
• https://www.steuern.de/krankheitskosten
• https://www.finanzamt.bayern.de/Informationen/Steuerinfos/Steuerberechnung/Zumutbare_Belastung/default.php?vlg=1&kinder=0&agb=4000&gbe=48770&s=Berechnen