Various deductions allow Dutch residents to save on taxes. Under certain conditions, you can deduct treatment costs for you, your relatives and people with disabilities living with you from the tax base. Some medical payments are not covered by your insurance and must be paid out of pocket - a medical expense deduction (aftrek zorgkosten) can help offset some of these costs.
Conditions for deducting medical expenses
To qualify for aftrek zorgkosten, you must meet the following conditions:
- Medical expenses are not covered by compulsory or voluntary health insurance. If you do not have a compulsory health insurance policy, medical expenses that the policy usually covers cannot be reimbursed. If you have a policy, but you went to a medical institution that does not have an agreement with your insurer, you will also not be able to compensate for expenses.
- Only medical expenses deemed necessary in accordance with the approved list are subject to deduction. The list of such expenses is below.
- You can only deduct medical expenses on your tax return for the year in which you spent the money.
- You can deduct only those expenses that you paid with your own funds or borrowed funds.
- If all these conditions are met, medical expenses associated with treatment abroad are deductible.
- If the tax authorities require confirmation of medical expenses, you will need to provide documents, so all invoices and receipts related to the costs of treatment and care must be kept for 5 years. If you have been granted a deferment for filing a declaration, the storage period for documents is 5 years + the deferment period.
- Only that part of medical expenses that exceeds established threshold levels, depending on the taxpayer's income, is deductible. Threshold levels are lower.
You can only deduct medical expenses if they were incurred to pay for medical services and goods purchased for the following categories:
- You and your tax partner,
- Your children under 27 years of age (if they cannot pay on their own),
- People over 27 years of age with whom you live and who cannot pay their own expenses and have a serious disability. Such disability implies the right to placement in a special institution for the care of people with disabilities in accordance with the Long-Term Care Act (Wet langdurige zorg - Wlz).
- Parents and siblings who live with you and are dependent on your care. People depend on your care when they typically require professional care in residential care or nursing homes.
Which medical expenses are deductible and which are not?
For 2023, you can check whether specific expenses are deductible in the following tables.
Costs associated with health insurance
| Costs | Possibility of deduction |
|---|---|
| Health insurance premiums | no |
| Statutory personal contribution | no |
| Personal Contribution Health Insurance Law | no |
| Health insurance franchise | no |
| Voluntary franchise | no |
Expenses for medical care, treatment and medications
| Costs | Possibility of deduction |
|---|---|
| Care in a hospital or other facility | Yes |
| Dentist, physiotherapist or other specialist | Yes |
| Treatment by a paramedic as prescribed and under the supervision of a doctor, for example, an osteopath or a prosthetist | Yes |
| Treatment by a paramedic without a doctor’s referral | yes, under certain conditions |
| Psychiatric care for persons under 18 years of age | no |
| Caring for a person with dyslexia (under 18 years of age) | no |
| Combination test or NIPT test for prenatal screening without medical indication | no |
| IVF treatment under 43 years of age | yes, under certain conditions |
| Prescribing medicine (including homeopathic remedies) in excess of the statutory personal contribution | Yes |
Expenses for auxiliary aids
| Costs | Possibility of deduction |
|---|---|
| Medical instep supports (Steunzolen) | Yes |
| Walkers (devices for walking on 3 or 4 legs), crutches (on the back, in the armpit, on the forearm), plaster supports for legs or wheelchairs | no |
| Wheelchairs | no |
| Hearing aid | yes, under certain conditions |
| Adjusting a car, bicycle, computer, etc. | Yes |
| Costs of using equipment (electricity, insurance, maintenance costs, rental, etc.) | Yes |
| Prostheses and pacemakers | Yes |
| Vaccinations for travel | Yes |
Fare
| Costs | Possibility of deduction |
|---|---|
| Travel to the doctor, hospital or pharmacy | Yes |
| Higher travel costs due to illness or disability | Yes |
| Travel expenses to visit patients | Yes |
Other expenses
| Costs | Possibility of deduction |
|---|---|
| Diet prescribed by a doctor or nutritionist | yes, a fixed amount is subject to deduction in accordance with list of diets for 2023 |
| Additional assistance to the family due to illness or disability | yes, under certain conditions |
| Additional clothing and bedding | yes, a fixed amount is subject to deduction |
Threshold amounts for qualifying for deduction of medical expenses
Deductions for medical expenses are made only to the extent that exceeds the established threshold amounts. When filling out a tax return for 2023, you need to focus on the threshold amounts indicated in the following tables
If you don't have a tax partner
| Income (euros per year) | Threshold amount |
|---|---|
| from 0 to 8603 | 149 euro |
| From 8604 45695 up | 1,65% of annual income |
| 45 and more | 753 euros + 5,75% of the amount over 45 euros |
If you have a tax partner
| Income (euros per year) | Threshold amount |
|---|---|
| from 0 to 17 206 | 298 euro |
| from 17 207 to 45 695 | 1,65% of annual income |
| 45 and more | 753 euros + 5,75% of the amount over 45 euros |
Aftrek zorgkosten is only one of the possible deductions. And besides deductions, there is also a list of tax discounts. To take into account all possibilities for reducing payments to the budget, order your tax return from our specialists.
