Medical Expense Deduction Calculator (Japan Iryohi Kojo)
Enter your annual medical expenses, insurance reimbursements, and total income to estimate the medical expense deduction and the resulting income and resident tax refund under Japan's official tax formula (Income Tax Act Article 73).
Tips
- Transportation costs for hospital visits (actual public transit fares) also qualify for the deduction. Taxi fares only qualify when public transit genuinely wasn't an option, such as an emergency.
- You can combine medical expenses paid for family members who share your livelihood (a spouse or dependents you support), so gathering receipts for the whole household can help maximize the deduction.
- Filing through e-Tax lets you skip attaching receipts, and you can use the data from the "medical expense notification" sent by your health insurer to reduce the work of preparing the statement.
- Cosmetic procedures, supplements for general health promotion, and routine health checkups (when no abnormality is found) are generally excluded — whether the expense was for treatment is the deciding factor.
FAQ
Side Note — Why the medical expense deduction has two different thresholds
The reason the deduction threshold switches from a flat 100,000 yen to "5% of income" for those with total income under 2M yen is a fairness design that accounts for differing ability to pay across income levels. If the threshold were a flat 100,000 yen for everyone, that amount would weigh relatively more heavily on lower-income households, making it harder for them to benefit from the deduction. Setting the bar at 5% of income lets lower-income households qualify from a smaller medical expense burden, bringing the relief closer to parity across income levels.
The deduction draws its line at whether an expense was for "treatment," because the underlying rationale for the tax deduction is relief for a reduced ability to pay taxes caused by unavoidable spending due to illness or injury. Cosmetic surgery or supplements for general health promotion are discretionary expenses that don't represent a reduced ability to pay, so they fall outside the deduction even though they're still spending related to one's body. This line is one of the most frequently asked-about points at tax offices every year.
Starting with the 2017 tax year filing, attaching or presenting receipts was no longer required by default — instead, submitting a "statement of medical expense deductions" became mandatory. This change was driven by the spread of electronic tax filing (e-Tax) and the introduction of the My Number system, aiming to simplify the filing process by using the "medical expense notification" data issued by health insurance associations. However, the obligation to retain the receipts themselves for 5 years remains, since a tax audit could still require you to present them even after preparing the statement.