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If you have an exceptionally high amount of illness-related expenses in a year, you can repeat at least some of the expenses on your tax return. However, your expenses must exceed the so-called »reasonable personal burden«. In short: the more you earn, the higher the burden you can be expected to incur.

Please note: costs for preventive health measures are generally not deductible as an extraordinary burden. This applies to vitamin preparations or dietary supplements, for example.

Reasonable burden

Inevitably, greater expenses must have arisen than the majority of taxpayers. Even if the medical expenses meet the criteria of a general exceptional burden, they are not fully taken into account in the tax return. The tax office deducts a "reasonable burden" from the expenditure. The amount of this reasonable burden depends on the life situation, annual income, marital status and number of children.

Medical expenses

Illness costs are costs caused by illness. However, only those expenses that are expended for the purpose of healing or with the aim of making the illness more bearable are considered illness costs. The costs of illness also include the expenses for a doctor, dentist, physiotherapist, psychotherapist and alternative practitioner. The costs must be proven to the tax office. If you have a persistent illness and you continue to need certain medicines, remedies and aids, it is sufficient to present your doctor's prescription once.

Naturopathic treatments can also be medically necessary - the costs for these are then also deductible. These include homeopathic and osteopathic treatments.

Please remember to deduct insurance reimbursements from costs before adding them as an exceptional expense. The travel costs for trips to the doctor are also included in the medical expenses.

Reasonable burden

Extraordinary burdens are only taken into account when calculating income tax insofar as the costs exceed the reasonable burden. The level of the reasonable burden is shown in the overview:

Reasonable burden for a total amount of incomeup to € 15,340from € 15,340 to € 51,130over € 51,130
for taxpayers without children, basic rate5%6%7%
for taxpayers without children, splitting tariff4%5%6%
for taxpayers with one child or two children2%3%4%
for taxpayers with three or more children1%1%2%

Examples:

You have received a dental bill for a total of € 2,400 for dental treatment.

Case 1:
They are married and have two children. The total amount of your income is € 27,500. This results in a reasonable charge rounded down to € 671.00 (2% of € 15,340 = € 306.80 and 3% of € 12,160 = € 364.80). You can deduct € 1,729.00 as an extraordinary charge.

Case 2:
You are single and have a daughter. Your total income is € 25,000. Thus, the reasonable charge is rounded down to € 596.00 (2% of € 15,340 = € 306.80 and 3% of € 9,660 = € 289.80). You have deductible extraordinary expenses in the amount of € 1,804.00.

Case 3:
They are married, have no children and are assessed together. Their combined total income is € 45,000. This means that you have a common reasonable charge rounded down to € 2,096.00 (4% of € 15,340 = € 613.60 and 5% of € 29,660 = € 1,483.00). The reasonable charge is exceeded by € 304.00, which you can deduct as an extraordinary charge.