What can I declare as treatment costs in the tax return?
Expenses incurred for a health cure 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 cure 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 cure.
The cure must be carried out under medical supervision. An exception is a climate cure, where a positive effect is achieved through the favourable climate, and no supervising doctor is required.
A prerequisite for a children's cure is usually the child's accommodation in a children's home.
You can deduct all health-related expenses that are not reimbursed by the health insurance as costs for the cure.
Cure 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 a cure, 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 an entry 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 not reasonable 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 cure is medically indicated due to the existing conditions (FG Münster, judgement of 23.2.2022, 7 K 2261/20 E).
