Tax glossary
Medical expenses (Krankheitskosten)
Medical expenses are doctor, dentist, hospital and therapy costs you pay yourself; they are tax-deductible to the extent they exceed 5 percent of your net income.
Medical and accident costs are deductible to the extent you bore them yourself — in other words, they were not reimbursed by your health insurer, accident insurance or employer. Besides doctors' bills, this includes the deductible (Franchise) and the co-payment (Selbstbehalt) under basic health insurance, dental treatment, prescribed therapies and medication, and nursing care.
There is a threshold: only the part of your costs above 5 percent of your net income is deductible. This applies both in the Canton of Zurich and for direct federal tax. Net income here means the figure before deducting the medical costs themselves and charitable donations. With a net income of CHF 80,000, you carry the first CHF 4,000 yourself.
Health insurance premiums do not belong here. They are covered separately by the insurance premium deduction, which is capped at a flat amount. Mixing premiums and medical costs is a common mistake and can lead the tax office to reject the whole list.
What counts as medical expenses
Deductible are costs for treatment that is medically necessary — to cure or relieve an illness or the consequences of an accident. Wellness and prevention without a medical prescription do not qualify.
- Deductible and co-payment as shown on your health insurer's statements
- Dentist and dental hygiene, children's braces
- Glasses and contact lenses, where not covered by supplementary insurance
- Prescribed physiotherapy, psychotherapy and medication
- Hospital stays and prescribed rehabilitation or spa treatment
- Nursing home and home care (Spitex) costs relating to care
Disability-related costs
An important exception: costs incurred because of a disability are deductible without the 5 percent threshold. These include aids and equipment, wheelchair-accessible alterations, care costs and transport. If you receive a helplessness allowance or have a recognised disability, list these costs separately.
The Cantonal Tax Office of Zurich (Kantonales Steueramt Zürich) publishes a dedicated leaflet on this. Getting the distinction right matters, as the difference between "with" and "without threshold" can easily amount to several thousand francs.
Bunch your costs
Because only the amount above the threshold counts, it pays to complete larger treatments within the same calendar year where possible. The year of payment is what matters. Dental work spread over two years may push you over the threshold in one year — or leave you below it in both, depending on when you pay.
- Add up the costs of the whole family — the threshold applies per tax return
- Keep invoices and your health insurer's benefit statements
- Pay for plannable treatments in the same year
Example: a dental implant and new glasses
A married couple in Winterthur-Wülflingen have a net income of CHF 96,000, so the threshold is 5 percent — CHF 4,800. During the year they pay for a dental implant (CHF 5,400), insurance deductible and co-payment (CHF 1,450 together), new glasses (CHF 650) and prescribed physiotherapy (CHF 300 own share).
Total own costs: CHF 7,800. Deductible: CHF 7,800 − CHF 4,800 = CHF 3,000. Without the implant, the total would have been CHF 2,400 — below the threshold, so no deduction at all. Had they paid the implant invoice in January instead, the deduction would have been lost in both years.
Frequently asked questions: Medical expenses (Krankheitskosten)
Can I deduct my health insurance deductible (Franchise)?
Yes. The deductible and the co-payment are costs you bear yourself and count as medical expenses. Your insurer's benefit statement serves as proof.
Is it worth listing medical costs if I stay below the threshold?
No, there is no deduction then. But always add up the costs for the whole family — often that is what takes you over the threshold.
Are alternative medicine costs deductible?
Generally yes if the treatment is prescribed by a doctor or provided by a recognised practitioner. Pure wellness offers or gym memberships are not deductible.
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