Medical Deduction
Medical Expense Deduction Guide for Foreigners【2026 · Scope · Calculation · Filing】
📋 Table of Contents
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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
Overview of tax filing in Japan
Beyond medical costs — all tax refunds via filing: salary, side jobs, mortgage.
Full tax filing guide