Taxation and medical expenses

Information

If you pay medical expenses that are not covered by the State or by private health insurance, you may claim tax relief on some of those expenses. These expenses include the costs involved in nursing home care. More information is available about tax relief on nursing home fees and for dependent relatives.

Tax relief is also available in Ireland for premiums paid for health insurance and for long-term care insurance (pdf). The insurance company grants this tax relief at source.

Rules

Who can you claim medical expenses for?

You can claim tax relief on medical expenses you pay for yourself and on behalf of any other person. The limitations on who you can claim for no longer apply for claims for the 2007 tax year onwards. 

You can claim medical expenses incurred for:

• Yourself or your spouse
• Your own child (or any other child of whom you have custody and you maintain at your own expense) under 18 years of age, or if over 18 years is receiving full-time education
• A child for whom you are granted Incapacitated Child Tax Credit.

You may also claim for any other person who is:

• A relative of yours or your spouse who is incapacitated by old age or infirmity from maintaining himself or herself
• Your widowed mother or father (or that of your spouse) whether or not they are incapacitated
• Your son or daughter who resides with you and on whose services you must depend due to old age and infirmity

The definition of 'relative' in the context of health expenses is very wide. It includes for example a spouse, parent, child, brother, sister, brother and sister-in-law and, parents-in-law. The definition also includes any other child (of whom the claimant has custody).

Health Insurance Tax Credit

If you are a member of an approved private health insurance scheme, you may get a tax credit. This tax credit is granted directly by the insurance company. Your premium will be reduced by the amount of the tax credit so you will probably not even notice that you have got a tax credit. This is known as Tax Relief at Source (TRS).

Subscribers to an approved private health insurance scheme pay a reduced premium (80% of the gross amount) to the insurance company. This is the same as giving tax relief at the standard rate of 20%.

Additional tax relief for health insurance starting for people aged 50 and over and increasing for higher age groups was introduced in 2009.

Additional Tax Relief for over 50's (2010)

It is not necessary to claim this relief it is granted directly by the insurance company (Tax Relief at Source).

Long-term care insurance

You can now receive a tax credit in respect of payments to long-term care insurance schemes. This will operate in the same way as the health insurance tax credit.

Medical Expenses

If you pay for certain medical expenses, you may be able to claim tax relief. This is the case if you cannot recover the expenses from any other source. You cannot claim tax relief for sums already received or due to be received from:

• Any public or local authority, for example the HSE (Health Service Authority)
• Any insurance policy
• Any other source, for example, compensation 

The medical expenses that attract tax relief are as follows:

• Costs of doctors and consultants fees
• Items or treatments prescribed by a doctor or consultant
• Maintenance or treatment in a hospital or an approved nursing home
• Costs of speech and language therapy carried out by a speech and language therapist for a qualifying child
• Transport by ambulance
• Costs of educational psychological assessments carried out by an educational psychologist for a qualifying child (allowable from 6 April 2001)
• Certain items of expenditure in respect of a child suffering from a serious life threatening illness
• Kidney patients' expenses (up to a maximum amount depending on whether the patient uses hospital dialysis, home dialysis or CAPD)
• Specialised dental treatment
• Routine maternity care
• In-vitro fertilisation

The following, where prescribed by a doctor, qualify for medical expenses relief:

• Drugs and medicines
• Diagnostic procedures
• Orthoptic or similar treatment
• Hearing aids
• Orthopaedic bed or chair
• Wheelchair or wheelchair lift (no relief is due for alteration to the building to facilitate a lift)
• Glucometer machine for a diabetic
• Engaging a qualified nurse in the case of a serious illness
• Physiotherapy chiropody/podiatry services or similar treatment
• Cost of a computer where it is necessary to alleviate communication problems of a severely handicapped person
• Cost of gluten-free food for coeliacs. As this condition is generally ongoing, a letter (instead of prescriptions) from a doctor stating that the individual is a coeliac sufferer is acceptable. Receipts from supermarkets in addition to receipts from chemists are acceptable.

Where qualifying health care is only available outside Ireland, you can also claim reasonable travelling and accommodation expenses. In such cases the expenses of one person accompanying the patient may also be allowed where the condition of the patient requires it.

The list of treatments and appliances that attract tax relief is added to from time to time. If you are undergoing a new procedure or availing of a new appliance, it is worthwhile claiming tax relief. For more information, see the Revenue information leaflet IT 6 (see 'How to apply' below) which is also available from your local tax office.

Dental and Optical Treatment

You cannot get tax relief for routine ophthalmic and dental care. Routine ophthalmic treatment covers sight testing, provision and maintenance of glasses and contact lenses. Routine dental treatment covers extractions, scaling and filling of teeth and provision and repairing of artificial teeth and dentures.

The following dental treatments do qualify for tax relief:

• Crowns
• Veneers/Rembrant Type Etched Fillings
• Tip Replacing
• Gold Posts
• Gold Inlays
• Endodontics - Root Canal Treatment
• Periodontal Treatment
• Orthodontic Treatment
• Surgical Extraction of Impacted Wisdom Teeth: this qualifies for tax relief when it is undertaken in hospital.
• Bridgework
• Dental Implants

Nursing Home Payments

Maintenance or treatment in a hospital includes maintenance or treatment in a nursing home. If you are paying the nursing home fees, you can get the tax relief - whether you are in the nursing home yourself or you are paying for another person to be there. Before 2007 this person must have been a relative or dependent, see above.

Child oncology patients and children with permanent disabilities

In the case of children receiving treatment for cancer (that is, child oncology patients) and children with permanent disabilities, tax relief may be claimed on the following as health expenses:

Telephone

Where a child oncology patient or a child with a permanent disability is being treated at home, you can claim a flat rate  payment to cover telephone rental and calls where those expenses are incurred for purposes directly connected with the treatment of the child.

Overnight accommodation

Tax relief is also allowable for parents or guardians of child oncology patients and children with permanent disabilities where the child is required to stay overnight in a hospital as part of their treatment and the parentor guardian is required to stay nearby. Relief is allowable on payments made to the hospital and/or hotel or Bed-and-Breakfast near the hospital for accommodation.

Travel

The cost incurred in travelling (unlimited journeys) to and from any hospital in respect of;

• The patient and accompanying parents or guardians and
• Parents or guardians of the patient

where such trips are shown to be essential to the treatment of the child. There is a mileage allowance if you use a private car.

Hygiene products and special clothing

Tax relief is also allowable for parents/guardians of child oncology patients and children with permanent disabilities for the cost incurred in respect of hygiene products and special clothing. This is subject to a maximum of €500 per year.

Kidney patients

Tax relief is granted under specific headings in respect of certain expenses incurred by kidney patients. The amount of relief depends on where the patient recieves care (for example, in hospital or at home).

Home dialysis and CAPD patients may claim tax relief on items such as electricity, telephone, laundry and travel expenses. Read more about kidney patients and tax relief on medical expenses here.

Rates

For claims up to and including 2008, you can get tax relief on health expenses at your highest rate of income tax for the year of the claim. From January 2009, tax relief on medical and health expenses incurred from 1 January 2009 will be given at the standard rate of 20%. However, tax relief on nursing home expenses will continue at your highest rate of tax.

Claims for the 2007 tax year on

Since 2007, you get tax relief on the total amount spent on qualifying health expenses.  

Claims up to and including the 2006 tax year

You must have spent €125 (claiming for one person) or €250 (claiming for more than one person) on health expenses before you qualify for tax relief. This means you do not get relief on the first €125 or €250 spent in 2006 or previous years. 

How to apply

You do not need to do anything about tax relief for health insurance or long-term care insurance because the credits are granted automatically at source (TRS).

You must apply separately for medical expenses relief.

Medical form MED 1 (pdf)  is used to claim tax relief on all general medical expenses (including dental expenses). You can only claim for medical expenses if you have receipts to prove your claim.

Do not send your medical receipts (this includes MED 2) with your MED 1 form. However, you must keep your medical receipts for six years because Revenue may investigate your claim.

A medical form MED2 (pdf) is a receipt to prove your dental expenses. Your dentist will normally have a supply of MED 2 forms and should complete it for you.

You can request these forms by using your mobile by sending a text message to 51829. Text the word 'FORM' followed by your PPS number and either 'MED1' (or 'MED2', if you need to provide your dentist with the form).

Relief is given by way of repayment at the end of the year. Since 1 January 2005, the time limit on claims for repayment of tax is four years.

Additional information is available on the Revenue information leaflet IT 6 or from PAYE Lo Call service. Contact information for all tax offices in Ireland is also available at the front of your telephone directory.

You can also claim tax relief online.