Taxation and Medical Expenses

Medical expenses

You can claim tax relief on medical expenses you pay for yourself and for any other person. You can claim relief only if you cannot recover the expenses from any other source. You cannot claim tax relief for amounts already received or due to be received from:

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

You can claim tax relief on:

• Costs of doctors and consultants fees
• Items or treatments prescribed by a doctor or consultant
• Maintenance or treatment in a hospital, treatment facility (such as a clinic) or a nursing home
• Cost of employing a qualified nurse at 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
• Treatment from a psychologist or psychotherapist
• Accupuncture
• Certain items of expenditure for 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, also qualify for medical expenses relief:

• Drugs and medicines
• Diagnostic procedures
• Orthoptic or similar treatment (for example, treatments for squints and eye movement disorders)
• 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 there is medical evidence that it is necessary to help a person with a severe disability to communicate
• Cost of gluten-free food for coeliacs and diabetic products for diabetics. As these medical conditions are generally ongoing, a letter (instead of prescriptions) from a doctor stating that the individual is a coeliac sufferer or diabetic is acceptable. Receipts from supermarkets in addition to receipts from chemists are acceptable.

Note: These lists are not exhaustive. Revenue add to the list of treatments and appliances that you can get tax relief on from time to time. If you are undergoing a new procedure or availing of a new appliance, it is worth checking whether you can claim tax relief. For more information, see the Revenue website.

You cannot claim relief for cosmetic surgery costs, unless you need the surgery as a result of a congenital abnormality, personal injury or disease.

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 generally 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). However, in some limited situations TRS does not apply, for example, where an employer pays the medical insurance premiums on behalf of an employee. This is treated as a Benefit in Kind and PAYE, PRSI and USC are due on the total amount. This means that the employee does not benefit from the TRS on the medical insurance premium and can make a claim directly to Revenue. You can get examples of how tax relief is applied where medical insurance premiums are paid directly by employers on Revenue’s website.

Since 16 October 2013, the relief is limited to the cost of the policy up to a maximum of €1,000 per adult and €500 per child. (A child was considered to be under 18 years of age, or under 23 years of age if in full-time education.) The relief is given at the standard rate of 20%.

Changes were announced for policies taken out or renewed on or after 1 May 2015. A child is considered to be a person under 21 years of age (whether or not they are in full-time education) as long as a child premium has been paid for them. For individuals 21 years of age and over, you can now claim relief at the amount set for adults, even if they are getting a child premium.

Additional age-related tax credits for health insurance starting for people aged 50 and over and increasing for higher age groups were introduced in 2009. From 2011, the additional relief started after age 60. In 2012, the age bands were narrowed. These age-related tax credits were replaced by a new risk equalisation scheme in 2013. Policies taken out or renewed after 31 March 2013 come under the revised scheme. You do not need to claim this relief as it is granted directly by the insurance company (Tax Relief at Source).

Long-term care insurance

You can now receive a tax credit for payments to long-term care insurance schemes. This operates in the same way as the health insurance tax credit.

Travelling abroad for treatment

You can claim tax relief on the cost of medical treatment you get outside the State. You can claim for treatment abroad that is also available in the State but you cannot claim travelling expenses for this care (see below).

The practitioner (GP, consultant or dentist) who provides your care must be entitled to practice in the country where the care is provided.

You can only claim for the cost of maintenance or treatment in a hospital, nursing home or clinic abroad if the hospital, nursing home or clinic provides access to 24-hour nursing on-site.

If the qualifying health care is only available outside Ireland, you can also claim reasonable travel and accommodation expenses. In such cases the expenses of one person accompanying the patient may also be allowed if the condition of the patient requires it. If the patient is a child, the expenses of one parent are usually allowed and, exceptionally, of both parents where it is clear that both need to be with the child.

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. You can get tax relief for orthoptic or similar treatment where prescribed by a doctor. 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

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.

Home nursing

You can claim relief on the cost of employing a qualified nurse at home at the standard rate of 20%. See the Revenue website for more information on employing a qualified nurse in the home.

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, you can claim tax relief 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 needs to stay overnight in a hospital as part of their treatment and the parent or 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 for:

• 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 allowed for parents/guardians of child oncology patients and children with permanent disabilities for the cost 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 receives 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.