Deducting medical expenses from tax: deductible, retention fee, dentist

Two deductions, two sets of rules

In your tax return, there are two separate deductions for health. If you mix them up, you give away money or receive a correction from the tax office.

This article deals with the second deduction, medical expenses. How the premium deduction works is explained in the article Deducting health insurance premiums from tax and the glossary term tax deduction.

The medical expenses deduction has a threshold: only what exceeds 5 % of your income is deductible. In a year with few doctor’s visits, it therefore brings nothing. In a year with an operation, dental treatment or new glasses, it can take a few hundred or thousand francs off your taxable income.

Step by step: how to claim medical expenses

1. Collect receipts all year. Doctor’s and dentist’s invoices, pharmacy receipts, invoices for glasses, your health insurer’s statements of benefits. In the canton of Bern, costs that were invoiced to you in the tax year and that you bore yourself count.
2. Wait for your health insurer’s annual certificate. The tax certificate shows the deductible and retention fee you paid during the year. If you had two health insurers, you need both certificates.
3. Add costs that are not covered. Dentist, glasses, contact lenses, medicines not covered by health insurance, therapies with a medical prescription. You subtract whatever a supplementary insurance has reimbursed.
4. Enter the total in the form. The tax administration calculates the 5 % threshold itself when issuing the assessment. In the canton of Bern, the threshold amount is then shown on the assessment notice.
5. Keep your receipts. According to the circular of the Federal Tax Administration (FTA), you must be able to prove the costs with invoices, proof of payment and insurance documents. You can store your invoices in your customer account.

What counts as medical expenses

The FTA defines illness and accident costs as expenditure on measures to maintain and restore physical or mental health. It lists medical treatment, hospital stays, medicines, vaccinations, medical devices, glasses and contact lenses, laser eye surgery and therapies. It has summarised its practice in Circular No. 11a of 26.05.2026; this applies from the 2027 tax period and replaces Circular No. 11 of 2005.

Costs	Deductible?	Condition
Deductible and retention fee of basic health insurance	yes	borne by yourself
Dental treatment, orthodontic correction, orthodontics, dental hygiene	yes	not purely cosmetic
Teeth whitening, beauty treatments	no	weight-loss cures and operations only with a medical prescription
Glasses, contact lenses, hearing aids	yes	subtract the insurance contribution
Physiotherapy, psychotherapy, occupational therapy, massages	yes	medically prescribed, carried out by qualified practitioners
Complementary medicine, recognised naturopaths	yes	therapist recognised under cantonal practice
Medicines	yes	prescribed by a doctor or recognised naturopath
Hospital contribution, single-room surcharge without medical reason	no	counts as living costs or comfort
Journeys to the doctor, gym membership, prevention courses	no	except medically necessary transport (ambulance)
Health insurance premiums	no	insurance deduction

Most dental treatment is not a compulsory benefit of basic health insurance (Art. 31 of the Federal Health Insurance Act, KVG). This is precisely why it often ends up in the tax return. When the health insurer does pay is explained on the page Does health insurance pay for the dentist?, and dental hygiene on the page Dental hygiene. What contribution is possible towards glasses is set out under Glasses. The glossary explains the term dental costs.

The FTA treats the hospital contribution of CHF 15 per day (Art. 104 of the Health Insurance Ordinance, KVV) as non-deductible because it mainly covers meals you would pay for at home anyway.

The legal rules in detail

Federal level. Under Art. 33 para. 1 let. h of the Federal Act on Direct Federal Taxation (DBG), you deduct the illness and accident costs for yourself and the persons you support, insofar as you bear the costs yourself and they exceed 5 % of taxable income after expenses. Expenses are the deductions under Art. 26 to 33 DBG, such as professional expenses, debt interest, pillar 3a and the insurance deduction.

Cantons. Art. 9 para. 2 let. h of the Federal Act on Tax Harmonisation (StHG) obliges all cantons to grant the same deduction, but cantonal law decides the amount of the threshold. According to its tax administration, the canton of Bern uses 5 % of net income, i.e. gross income after deducting expenses and general deductions. If you live in another canton, the threshold is in that canton’s tax return guide.

Disability. Costs due to a disability within the meaning of the Disability Discrimination Act are deductible without a threshold (Art. 33 para. 1 let. hbis DBG). The FTA circular describes how they are distinguished from ordinary medical expenses.

Children and supported persons. You can claim the costs of your minor children or children in education in addition to the child deduction. They go into the same total and the same threshold.

Co-payment. The deductible is the fixed amount you first pay yourself each year; for adults it is CHF 300 to CHF 2,500. After that, you bear a 10 % retention fee, at most CHF 700 a year, and at most CHF 350 for children (Art. 64 KVG, Art. 103 KVV).

Sample calculation: deductible of CHF 300 or CHF 2,500

Example with fictitious people. Nadia, 38, lives in the city of Bern. We set her net income at CHF 60,000 (assumed); the threshold is therefore CHF 3,000. For the calculation, we assume that the assessment basis is the same for federal and cantonal tax. During the year, she has doctor’s and hospital invoices of CHF 6,000 that go through basic health insurance, dental treatment of CHF 1,400 and new glasses for CHF 450 (amounts assumed, no supplementary insurance).

Tax is a side effect when choosing your deductible, not the main reason. What matters is how high your costs are likely to be. You can work this out with your own figures in the deductible calculator; this example is not a recommendation.

Special cases

• Families. The costs of all the people you support go into the same calculation. For children, the retention fee of basic health insurance is at most CHF 350 a year, and there is no standard deductible for them (Art. 64 para. 4 KVG). Braces often fall in the same years as other costs and can push you over the threshold.
• Supplementary insurance. If your supplementary insurance pays part of the dentist’s or glasses invoice, only the rest is deductible. The supplementary insurance premium belongs in the insurance deduction, not in medical expenses. What a supplementary insurance pays is set out in its general terms and conditions; you can compare products under Supplementary insurance.
• Supplementary benefits. If you receive supplementary benefits to AHV or IV, the canton reimburses you, among other things, for the co-payment of basic health insurance and dental treatment (Art. 14 of the Federal Act on Supplementary Benefits, ELG). What the canton reimburses, you do not bear yourself and cannot deduct.
• Special diet. From the 2027 tax period, for a medically prescribed, vital special diet, a flat rate of CHF 1,500 per year and per person affected can be claimed for federal tax; it counts towards the 5 % threshold (Circular No. 11a).
• Care at home. Illness-related care by Spitex or private carers is deductible, housework is not. Unpaid care by relatives does not give rise to a deduction.
• Premium subsidy. It lowers your premium and therefore the amount in the insurance deduction, not your medical expenses. Whether you are entitled is explained in the article Applying for a premium subsidy.

Common mistakes

• Entering premiums as medical expenses. Premiums belong in the insurance deduction. The tax office removes them from medical expenses.
• Not subtracting reimbursements. Only what you bore yourself is deductible. Contributions from basic or supplementary insurance towards glasses or the dentist do not belong in the total.
• Only entering the annual certificate. Dentist, glasses and costs not covered by health insurance are not on it. If you forget them, you often stay just below the threshold.
• Entering therapies without a prescription. The FTA only recognises physiotherapy, massages or psychotherapy with a prior medical prescription; a general recommendation is not enough.
• Calculating the threshold from your gross salary. What counts is income after deductions, for federal tax under Art. 26 to 33 DBG, in Bern net income.

You will find other ways to reduce healthcare costs in the Saving money section. Switching health insurer or model often brings more than any deduction: the premium calculator shows all offers in your municipality, and the profiles under Health insurers show the insurers’ key figures. Whether you are entitled to a premium subsidy is shown on the Premium subsidies page.