SteuerGo FAQs

(2023) What medical expenses can I deduct?

As medical expenses, you can deduct all costs incurred in connection with an illness. You can enter these in your tax return as extraordinary expenses without any 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
• medications
• pharmacy co-payments
• medical aids
• hospital stays
• trips 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 (ticket, train ticket). 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, for example.

For health courses aimed at fitness or weight reduction that are not prescribed by a doctor, you should try to get 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 you enter them in the tax return. However, you do not have to have payments from daily sickness allowance insurance credited.

 

Statutory health insurance companies often offer their customers bonus programmes for health-conscious behaviour under § 65a SGB V and then pay cash bonuses for this. The health insurance companies can determine for themselves which services are rewarded, e.g. preventive examinations, vaccinations, healthy eating, or sporting activities. Such bonus payments to promote health-conscious behaviour are not a refund of contributions. Therefore, the health insurance contributions deductible as special expenses are not reduced (BFH ruling of 1.6.2016, X R 17/15; BFH ruling of 6.5.2020, X R 16/18).

However, there are still services provided by statutory health insurance companies that are considered "genuine" refunds of contributions and therefore reduce the deduction for special expenses.

Currently, the Federal Ministry of Finance has once again commented on the distinction between bonus payments and refunds of contributions (BMF letter of 16.12.2021, BStBl 2022 I p. 155). According to this, among other things:

• Refunds of contributions that reduce the deduction for special expenses also include premium payments under § 53 SGB V. These are, for example, premiums for insured persons participating in general practitioner-centred care. If the benefit is granted in the form of bonus points, these must be converted into Euro and reported as a refund of contributions. Bonuses for family-insured bonus programme participants are to be attributed to the main insured person.
• A refund of contributions also exists if a bonus from the statutory health insurance relates to a measure covered by basic health insurance (in particular health prevention or protection measures, e.g. for the early detection of certain diseases) or is paid for behaviour independent of expenditure (e.g. non-smoking status, healthy body weight).
• If the statutory health insurance reimburses or rewards costs for health measures under a bonus programme according to § 65a SGB V that are not included in the regular insurance coverage of basic health insurance (e.g. osteopathy treatment) or serve to promote health-conscious behaviour (e.g. membership in a sports club or gym) and have been or are privately financed by the insured, this is not a refund of contributions. The health insurance contributions deductible as special expenses are therefore not to be reduced by the amount of the cost reimbursement or the bonus attributable to it. A flat-rate bonus payment does not have to cover the actual costs incurred exactly.

 

Tip 1: For simplification purposes, it can be assumed that bonus payments made on the basis of § 65a SGB V do not reduce the deduction for special expenses up to an amount of 150 Euro per insured person. If the bonus payments exceed this amount, the amount exceeding this is a refund of contributions that reduces the deduction for special expenses. The taxpayer is free to prove that there is no refund of contributions for bonus payments of more than 150 Euro. This means they must demonstrate that the bonus payments under § 65a SGB V were made to promote health-conscious behaviour. This regulation applies in all open cases and for payments made up to 31 December 2023.

Tip 2: In fact, statutory health insurance companies are required to check whether a payment that is neutral or reduces special expenses has been granted. They must inform the tax authorities electronically, and the corresponding data is then automatically included in the respective tax assessment. However, experience shows that the programme-controlled notifications are not always correct. And the current non-objection limit of 150 Euro is likely not to have been observed in many cases. Therefore, check whether the correct values have been applied in your tax assessment.

Tip 3: At the end of 2020, the Federal Fiscal Court ruled that bonus payments from private health insurance "to promote cost-conscious behaviour" are to be regarded as a refund of contributions 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 of 16.12.2020, X R 31/19).