Medical expenses

What are medical expenses?

In everyday language, “medical expenses” (Krankheitskosten) means everything an illness costs. In health insurance and tax law the term is narrower: it means the costs of maintaining or restoring physical or mental health that you bear yourself because no insurer covers them. The Federal Tax Administration (FTA) gives as examples medical treatment, hospital stays, medicines, vaccinations, medical devices, glasses and contact lenses.

The most important medical expenses for insured persons are:

• Co-payment in basic health insurance: the deductible (Franchise) and a 10% retention fee, up to CHF 700 a year for adults. Together they make up the co-payment.
• Services that no insurer pays for: for example, most dental treatment, glasses beyond an insurer’s contribution, or therapies prescribed by a doctor that basic health insurance does not cover.
• Retention fees in supplementary insurance and amounts above its maximum benefits.

Health insurance premiums are not included. Nor are costs for pure comfort, such as surcharges for a single room without a medical reason, cosmetic treatments or spa treatments that have not been prescribed.

The term differs from healthcare costs in its perspective: healthcare costs means the total costs of the healthcare system, according to the FSO CHF 97,201 million in 2024. Of this, households paid 21.5% directly as out-of-pocket payments, in other words co-payments and services they paid for themselves. This part comes closest to what you pay yourself as medical expenses.

How it works

Federal tax deduction

For direct federal tax, you can deduct illness and accident costs you have borne yourself, for yourself and for people you support. However, only the part that exceeds 5% of your taxable income after deduction of expenses. Expenses include, for example, professional expenses, interest on debts, contributions to pillar 3a and the deduction for insurance premiums. You must provide evidence of the costs with invoices, proof of payment and insurer statements; for certain therapies, the tax authority requires a doctor’s prescription.

The FTA has summarised its practice anew in Circular No. 11a of 26.05.2026; it applies from the 2027 tax period and replaces Circular No. 11 of 2005. According to it, dental treatment is deductible if it treats dental disease or is for tooth correction, orthodontics or dental hygiene, but purely aesthetic treatments are not.

Cantonal tax deduction

The cantons must also grant the deduction but set the threshold themselves. You can find the rules and forms in your canton’s tax return guide.

Disability-related costs

Costs incurred because of a disability within the meaning of the Disability Discrimination Act are fully deductible without a threshold. The distinction from ordinary medical expenses is described in the FTA circular.

Reimbursement through supplementary benefits

If you receive supplementary benefits to your old-age, survivors’ or invalidity pension, the canton also reimburses certain illness and disability costs, including the co-payment of basic health insurance, dental treatment and transport to the nearest place of treatment. The cantons may set maximum amounts, but for single people living at home these may not be lower than CHF 25,000 a year.

Legal basis

• Art. 33 para. 1 let. h of the Federal Act on Direct Federal Taxation (DBG): illness and accident costs of the taxpayer and of the people they support are deducted from income, to the extent that the taxpayer bears the costs and these exceed 5% of taxable income reduced by expenses (Art. 26–33 DBG).
• Art. 33 para. 1 let. hbis DBG: disability-related costs are deductible to the extent that the taxpayer bears them, without a threshold.
• Art. 9 para. 2 let. h StHG: the cantons grant the deduction of illness and accident costs to the extent that they exceed a threshold set by cantonal law.
• Art. 64 KVG and Art. 103 KVV: co-payment in basic health insurance with a deductible and a 10% retention fee up to CHF 700 (children CHF 350).
• Art. 14 ELG: the cantons reimburse recipients of supplementary benefits for, among other things, dental treatment, help and care at home, transport, aids and the co-payment under Art. 64 KVG; minimum maximum amounts under para. 3.

Example: deduction for direct federal tax

Beat is 58, single and has a deductible of CHF 2,500. This year he had high treatment costs, plus dental treatment that no insurer pays for. His income and the dentist’s bill are assumptions for the calculation; the deductible, retention fee and threshold are the statutory values.

What this means for you

1. Collect your documents. Keep invoices, proof of payment and your insurer’s statements of benefits. Ask your insurer for an overview at the end of the year.
2. Work out the threshold. If the costs you paid yourself are well below 5% of your net income, the federal deduction brings nothing. With high costs, for example after an operation or with expensive dental treatment, adding them up is worthwhile.
3. Choose the right deductible. The deductible determines how much co-payment you have to bear. If you regularly have high medical expenses, a low deductible can be cheaper. The premium calculator shows the comparison with your premiums; the dates for a change are listed under deadlines.
4. Check supplementary benefits. If you receive an old-age, survivors’ or invalidity pension and have a low income, you may be entitled to supplementary benefits, which also reimburse medical expenses.

You can see which insurers there are and how they are positioned under health insurers.

Common mistakes

• Entering premiums as medical expenses. Premiums belong under the deduction for insurance premiums, not under medical expenses.
• Deducting amounts paid by the insurer. Only what you have borne yourself is deductible.
• Forgetting the threshold. Only the part above 5% of net income (federal) or above the cantonal threshold is deductible.
• Including cosmetic treatments. Cosmetic treatments and spa treatments that have not been prescribed are not medical expenses.
• Forgetting the children’s co-payment. Costs for people you support also count.

How we build examples is explained under how we calculate.