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Medical expenses deductions

Medical expenses deductions are part of a system whereby if the amount of medical care costs paid in one year, including those of family members, exceeds a certain standard, you can file a final tax return with the tax office to have the excess amount of medical care costs deducted from your taxable income and have some of your taxes refunded.

Check with your nearest tax office for details, including how to conduct the necessary procedures. Information is also available on the National Tax Agency website.

National Tax Agency website: http://www.nta.go.jp
In addition to finding out how to file for medical expenses deductions, you can also go to this website to prepare your final tax return and other documents.

How are medical expenses deductions calculated?

When is the filing period for final tax returns?

The filing period for a final tax return is the one-month period from February 16 through March 15. However, if you earn salary income, you can apply for reimbursement of medical expenses deductions or other amounts from January.

What documents are needed to file a final tax return?

The documents and other items needed include the final tax return form which can be prepared at the National Tax Agency website, your certificate of income and withholding tax, your official seal, and your deposit passbook of the account where you would like to receive your reimbursement.

Starting with income tax returns filed for 2017 income, when filing your tax return, you must attach medical expense deduction details to claim medical expenses deductions (including those under the self-medication tax system) instead of attaching or presenting receipts for medical care costs or medicinal costs.**
In addition, while you must retain receipts for medical care costs and other costs associated with your income tax return for five years from the deadline for filing the tax return or other applicable date, if the attached medical care cost information meets certain requirements, you no longer need to retain the receipts for medical care costs and other costs attested in the medical care cost information.

  • ** From mid-February, the Health Insurance Society will post the data for the declaration of medical expenses deductions on the web-based medical care cost information.
    This applies when filing your income tax return for 2017 and later on or after January 1, 2018. (As a transitional measure, you may also attach or present receipts instead of medical care cost details for the years 2017-2019.)

Examples of costs eligible for medical expenses deductions

  • Costs of treatment paid to a medical care institution
  • Cost of purchase of drugs for treatment
  • Costs of going to the hospital, house-call costs
  • Share of inpatient meal and living expenses you paid
  • Costs of dental care not covered by insurance
  • Costs of medical consultations from pregnancy through after childbirth and childbirth expenses
  • Costs of massage, acupressure therapy, acupuncture, and moxibustion
  • Costs of purchase of artificial arms, artificial legs, etc.
  • Costs of adult diapers for a person bedridden for six months or longer, with a certificate from a doctor
  • Costs of use of health promotion centers involving use of hot springs or exercise, with a doctor's instruction and certificate
  • Costs of use of visiting nurse stations
  • Costs of use of health services facilities for the aged and convalescent facilities (patient cost-sharing for long-term care expenses, meal expenses, and accommodation expenses)
  • One-half of patient cost-sharing for long-term care expenses, meal expenses, and accommodation expenses at special nursing homes for the elderly
  • Patient cost-sharing for long-term care expenses when receiving long-term care services at home together with medical care services based on a service plan for persons identified as needing long-term care
  • Costs of specific health checkups and specific health guidance for persons eligible for certain active support services as part of specific health guidance

The self-medication tax system (special exception for medical expense deductions)

The self-medication tax system (special exceptions for medical expense deductions) is a system of special exceptions for medical expense deductions intended to encourage switching from use of prescribed drugs under appropriate health management.

System overview

Under this system, by completing a final income tax return, taxpayers who receive health examinations, vaccinations, or other services for the purposes of health maintenance and promotion or disease prevention and purchase more than 12,000 yen’s worth of eligible over-the-counter drugs per year may deduct from their annual gross income the amount of such costs in excess of 12,000 yen (up to a maximum of 88,000 yen).

  • ** Over-the-counter (OTC) drugs: Drugs that can be purchased at pharmacies, drug stores, and elsewhere without a prescription from a doctor (general nonprescription drugs, drugs requiring guidance).

Eligible period

January 1, 2017 - December 31, 2021

Persons eligible to claim the deduction

Those eligible to claim the deduction will meet all three of the following conditions for the year in question (January-December):

  • Pay both income tax and resident tax.
  • Purchase more than 12,000 yen in eligible over-the-counter drugs during the year (including over-the-counter drugs purchased for dependent spouse and/or other dependent family members)
  • Undergo at least one of the following services for purposes of health maintenance and promotion or disease prevention:
    • Health examinations provided by a health insurance society or other party (e.g., complete check-ups and various examination and screening services)
    • Health examinations provided by municipal governments as health improvement (health examinations for persons such as public assistance beneficiaries)
    • Vaccinations (periodic vaccinations or influenza vaccinations)
    • Periodic health examinations provided by employers (employer examinations)
    • Specific health checkups (so-called metabolic syndrome examinations) and specific health guidance
    • Cancer examinations provided by municipalities
  • ** Health examinations provided by municipalities as services for residents and funded by local governments are not eligible.
  • ** Optional health examinations paid for entirely by the patient are not eligible.

Eligible drugs

Eligible drugs are those that previously required a prescription from a doctor but can now be purchased over the counter at drug stores (Rx-to-OTC switch drugs).
Visit the website of the Ministry of Health, Labour and Welfare for Information on eligible active ingredients, products, etc.

Reference link

Packages of eligible products will show the following identifying mark to help you determine which products to purchase following adoption of this system.

Relationship to ordinary medical expense deductions

You cannot combine deductions from income under the self-medication tax system and ordinary medical expense deductions. Eligible persons must choose whether to use ordinary medical expense deductions or the self-medication tax system for the cost of eligible drugs you purchased.

For information on specific procedures for completing final income tax returns and other matters, check with your nearest tax office, the website of the National Tax Agency, or other sources.