# Medical expense deduction (医療費控除) for foreign residents in Japan

URL: https://japanhow.com/money/tax/medical-expense-deduction-japan/
Author: JapanHow editors
Updated: Oct 26, 2026

## Summary

The medical expense deduction (医療費控除) lowers your income tax when you paid large medical bills in a year. As of October 2026, the National Tax Agency counts medical costs above ¥100,000, or above 5% of total income if that is under ¥2 million, up to a ¥2 million maximum, after insurance payouts are subtracted. You claim it on a tax return, not through the year-end adjustment. Keep receipts for 5 years. Medical bills paid to a foreign doctor can count.

## Key facts

- Threshold: ¥100,000 or 5% of income
- Maximum deduction: ¥2,000,000
- How to claim: Tax return with a 明細書
- Keep receipts: 5 years

The medical expense deduction (医療費控除, iryōhi kōjo) takes part of your medical bills off your taxable income, so you can get some income tax back. As of October 2026, the National Tax Agency (国税庁) counts the part of your costs **above ¥100,000** (or above 5% of your total income, if that is under ¥2 million), up to a maximum deduction of **¥2,000,000**. You claim it on a tax return, not through your employer.

**Threshold:** ¥100,000 or 5% of income (Use 5% of total income (総所得金額等) when it is under ¥2 million. Maximum deduction ¥2,000,000 (National Tax Agency, No.1120).)

## How is the medical expense deduction calculated?

The National Tax Agency gives this formula:

**Deduction = (medical costs you paid − insurance payouts) − threshold**

The threshold is ¥100,000, or 5% of your total income if that is under ¥2 million. The result is capped at ¥2,000,000.

Two examples, to show the arithmetic only. They are not tax advice.

| | Example A | Example B |
|---|---|---|
| Total income (総所得金額等) | ¥3,000,000 | ¥1,500,000 |
| Medical costs paid | ¥250,000 | ¥250,000 |
| Insurance payouts | ¥0 | ¥0 |
| Threshold | ¥100,000 | ¥75,000 (5%) |
| Deduction | ¥150,000 | ¥175,000 |

The deduction lowers your taxable income. How much tax you get back depends on your tax rate and on what was withheld, so the deduction is not the refund.

Costs count in the year you **actually paid** them. An unpaid bill counts in the year you pay it.

## Does it cover my family, and is it only for permanent residents?

The National Tax Agency page covers costs you paid for yourself, or for a spouse or relative who shares your household budget (生計を一にする). The page does not mention visa type, nationality or permanent residency. We could not confirm from the official pages how it treats relatives who live abroad, so ask the tax office or a licensed tax accountant (税理士) before you include them.

## What medical costs count?

The agency's list is about treatment of an illness or injury. Examples it gives:

- Medicine to treat an illness, such as cold medicine.
- Public transport to and from treatment. Taxis count only when public transport is not available.
- Room and meal charges during a hospital stay.
- Dentist treatment and dentures. Gold and porcelain count as standard materials.
- Glasses, hearing aids, crutches and similar items needed for treatment.
- Treatment by a licensed massage therapist, acupuncturist or bonesetter.
- Fees for a licensed nurse or a hired caregiver.
- Midwife fees. Prenatal checkups and tests after pregnancy is diagnosed also count, with the cost of getting there.

### What does not count?

- Gasoline and parking if you drive your own car to the clinic.
- Taxis when public transport is available.
- Vitamins taken for prevention or general health.
- Massage for relaxation.
- Payments to a relative for caring for a patient.
- Orthodontics to improve appearance. Correcting a growing child's bite can count.
- Routine health checkups, generally. A checkup can count if it finds a serious condition and you then receive treatment. Our [health checkup guide](/life/health/health-checkup-japan/) explains checkups in Japan.
- For a birth: travel to your parents' home to give birth, nightwear, toiletries and meals from outside the hospital.

## What do I subtract before I calculate?

Subtract money you got back for the same costs. The National Tax Agency lists insurance payouts, high-cost medical care benefits (高額療養費), family medical benefits and childbirth lump-sum payments (出産育児一時金). The maternity allowance (出産手当金) does not need to be subtracted.

A payout reduces only the costs it covers. If it is bigger than those costs, the excess cannot be subtracted from your other medical bills.

If you are on National Health Insurance, our [National Health Insurance guide](/money/insurance/national-health-insurance-japan-foreigners/) explains what you pay at the counter.

## Can I claim treatment I paid for abroad?

Yes. The National Tax Agency says payments to a foreign doctor are eligible. If you paid in a foreign currency, convert the amount to yen at the telegraphic transfer middle rate (TTM) on the payment date.

We could not confirm from the official pages whether receipts in a foreign language need a Japanese translation. Ask your tax office before you file.

## How do I claim it as an employee?

If your employer does your year-end adjustment (年末調整), you still claim medical expenses yourself. The National Tax Agency says to file a final tax return (確定申告) with your local tax office and attach a medical expense statement (医療費控除の明細書).

If you were not required to file but tax was withheld from your pay, you can file a refund return (還付申告). The National Tax Agency allows this from **1 January of the next year for 5 years**. If nothing was withheld, there is no refund. The regular filing period is generally 16 February to 15 March.

For dates, e-Tax and what a My Number card does, see our [tax return guide](/money/tax/tax-return-japan-foreigners/). To see what your employer already handles, read the [year-end adjustment guide](/money/tax/year-end-adjustment-tax-return-foreigners/).

## What should I bring or keep?

- Receipts for every payment you list, kept at home for 5 years from the filing deadline.
- The 明細書 you filled in.
- Your insurer's medical expense notice (医療費通知), if you have one. With one, the National Tax Agency says you do not need to keep the receipts it covers.
- If you file by e-Tax, medical expense notice data can be pulled through My Number Portal (マイナポータル) and sent with the return, according to the National Tax Agency.

If you do not understand a Japanese receipt, our guide to an [English-speaking hospital](/life/health/english-speaking-hospital-japan/) may help you find clinics that support patients in English.

## What is the self-medication tax scheme?

The self-medication tax scheme (セルフメディケーション税制) is an alternative for people who buy specified over-the-counter drugs. It applies to purchases above ¥12,000, up to a maximum deduction of ¥88,000. You must have done certain health checkups or vaccinations. You choose either this scheme or the regular deduction, not both.

**Not tax advice:** This page explains the National Tax Agency's published rules as of October 2026. For your own case, such as relatives abroad or a year when you moved to or from Japan, ask your tax office or a licensed tax accountant (税理士).

More guides: [tax return in Japan](/money/tax/tax-return-japan-foreigners/), [year-end adjustment](/money/tax/year-end-adjustment-tax-return-foreigners/), [National Health Insurance](/money/insurance/national-health-insurance-japan-foreigners/), [health checkups in Japan](/life/health/health-checkup-japan/).

## Questions people ask

### Is the medical expense deduction only for people with permanent residency?

The National Tax Agency page on the deduction does not mention visa type or permanent residency. It speaks of costs you paid for yourself or a relative who shares your household budget.

### Can I claim a medical expense deduction for treatment abroad?

Payments to a foreign doctor are eligible, according to the National Tax Agency. If you paid in a foreign currency, convert it to yen at the TTM rate on the payment date.

### How long do I have to claim the medical expense deduction?

If you are an employee who already had tax withheld, you can file a refund return (還付申告) from 1 January of the next year for 5 years. Counting from the 2026 costs, that starts on 1 January 2027.

### Do health checkups count for the medical expense deduction?

Generally no. A checkup can count only if it finds a serious condition and you then receive treatment for it.

### Can I use the medical expense deduction and the self-medication tax scheme together?

No. You choose one or the other. The self-medication scheme (セルフメディケーション税制) covers specified over-the-counter drugs above ¥12,000, up to ¥88,000.

## Sources

- [No.1120 医療費を支払ったとき（医療費控除）](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1120.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.1122 医療費控除の対象となる医療費の範囲](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1122.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.1122 Q&A 医療費控除の対象となる医療費](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1122_qa.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.1119 医療費控除に関する手続について](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1119.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.1124 出産費用と医療費控除](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1124.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.1128 歯の治療費と医療費控除](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/1128.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.2030 還付申告](https://www.nta.go.jp/taxes/shiraberu/taxanswer/shotoku/2030.htm), National Tax Agency (国税庁) (accessed Oct 26, 2026)
- [No.12011 Final tax return](https://www.nta.go.jp/english/taxes/individual/12011.htm), National Tax Agency (accessed Oct 26, 2026)