Medical Deduction
Medical Expense Deduction Guide for Foreigners【2026 · Scope · Calculation · Filing】
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📋 Table of Contents
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💡 Key Points
- The Medical Expense Deduction is a scheme where, if medical expenses paid within a year exceed a certain threshold (in principle 100,000 yen, or 5% of income for those earning under 2 million yen), the excess can be deducted from taxable income, and you may receive a refund of income tax and resident tax by filing a tax return (refund filing) if you meet the requirements.
- Any Japan resident is eligible regardless of nationality or residence status, and non-permanent residents (within 5 years of arrival) may also be eligible within a certain scope.
- Eligible expenses are medical costs for treatment purposes (medical treatment fees, prescription and OTC drugs, dental treatment, childbirth costs, etc.); expenses for prevention or cosmetic purposes (health checkups, vaccinations, cosmetic surgery, etc.) are in principle not eligible.
- Since this is not handled through year-end adjustment for company employees, you need to file your own tax return (refund filing), and you can claim retroactively for up to the past 5 years.
What is the Medical Expense Deduction?
A scheme where medical expenses paid in a calendar year that exceed a threshold can be deducted from taxable income, reducing your income tax and resident tax. Employees may receive a refund by filing a tax return if they meet the requirements.
💡 Example: ¥200,000 annual medical bills means ¥100,000 (the amount over ¥100,000) becomes deductible. At a 30% combined tax rate, you get back about ¥30,000.
Are Foreigners Eligible?
Yes. Any Japan tax resident (with Japanese address, living 1+ year) qualifies. Medical expenses of household members (under same economic unit) can be combined into one claim.
Deductible vs Non-Deductible
✅ Deductible
- Hospital/clinic visits, treatment fees
- Prescription and OTC drugs (for treatment)
- Dental treatment (cavities, extraction)
- Childbirth (prenatal checks, delivery, hospital stay)
- Fertility treatment
- Public transport to hospital
- Massage, acupuncture (for treatment)
❌ Not Deductible
- Annual health checkups (if no illness found)
- Vaccinations
- Cosmetic surgery, teeth whitening
- Supplements, health foods
- Regular eyeglasses/contacts
- Cosmetic orthodontics
- Amounts reimbursed by insurance
- Childbirth lump-sum subsidy portion
How to Calculate the Deduction
Deduction = Medical expenses − Insurance reimbursements − ¥100,000 (or 5% of income, whichever is lower, for incomes under ¥2M). Cap is ¥2M.
CASE 1
¥5M income, ¥250K medical expenses
Deduction ¥150K → Refund ~¥45K
CASE 2
Childbirth: ¥600K paid, ¥420K subsidy
Deduction ¥80K → Refund ~¥24K
Self-Medication Tax (OTC Special)
An alternative simpler scheme (choose one of the two). Best for those who buy lots of OTC medicine:
- Target: designated OTC drugs (switch OTC etc.)
- Minimum: ¥12,000
- Maximum: ¥88,000
- Requirement: Had a health checkup, vaccination, or cancer screening that year
Filing Steps
- Collect 1 year of receipts and statements
- Prepare the "Medical Expense Deduction Statement"
- File via e-Tax (requires My Number Card) or at tax office
- Refund arrives in your bank account in 3 weeks–2 months
⚠️ Receipts must be kept for 5 years. Phone photos are OK.
Notes When Leaving Japan
- Medical expenses from Jan 1 to your departure date are still deductible
- Before departure, file a "quasi-final return" OR appoint a Tax Manager
- Refund goes to a Japanese bank account — keep it open
- You can also retroactively claim for the past 5 years
For the basics of tax filing (who qualifies, required documents, e-Tax steps), see the foreigner's tax filing and resident tax guide. You can also claim furusato nozei, a donation scheme that reduces income and resident tax, on the same tax return.
Frequently Asked Questions (FAQ)
I threw away my receipts. Can I not claim the deduction?
If you receive a 'Medical Expense Notification' (sent once a year) from your health insurance association, it can serve as a substitute for receipts. Over-the-counter medicine and transportation costs need to be recorded, so from now on keep notes or photos.
Does medical treatment received overseas count?
In principle, no. Only costs at medical institutions within Japan count. However, treatment received at an overseas branch of a Japanese medical corporation while on overseas assignment or travel may exceptionally be included.
I'm a stay-at-home spouse on a spouse visa. Can I claim my husband's medical expenses myself?
No, it's better for the person with income (i.e., your husband) to claim it, since the refund will be larger. Medical expenses for family members living on the same household budget can be claimed by any of them, but it's more advantageous for the person with the higher tax rate to claim them together.
Childbirth costs were 600,000 yen, and I received a 420,000 yen childbirth lump-sum allowance. Can I claim the deduction?
Yes. 600,000 − 420,000 = 180,000 yen is eligible for deduction (the 80,000 yen portion exceeding 100,000 yen). Prenatal checkups, delivery, and hospitalization costs can all be included.
What if I don't have eTax or a My Number card?
You can submit a paper return at the tax office counter. Alternatively, you can file using the notification card plus an ID document (My Number must still be written). Having a My Number card lets you complete everything online, which is more convenient.
How should I record train fares for hospital visits?
Note the date, hospital name, route, and amount (Excel or a smartphone app works). No receipt is needed, but you should be able to answer if the tax office asks. Taxi fares are generally not eligible (only when necessary, such as for serious illness or young children).
I forgot to claim medical expense deductions in the past. Can I do it now?
Yes, you can file a retroactive refund claim going back up to 5 years. For example, medical expenses from 2021 can be claimed until December 31, 2026. Check any year in which your medical expenses exceeded 100,000 yen.
Overview of tax filing in Japan
Beyond medical costs — all tax refunds via filing: salary, side jobs, mortgage.
Full tax filing guide