Medical Expenses Deduction

Key Takeaways

You can deduct certain out-of-pocket medical expenses (specifieke zorgkosten) from your Dutch taxes.
Only expenses not covered by your health insurance or other schemes are deductible.
There is an income-dependent threshold — you can only deduct costs above this threshold.
Qualifying expenses include: own-risk payments, prescribed medications, medical aids, transport to medical appointments, and certain dietary costs.
This deduction is particularly valuable for people with chronic conditions or disabilities who have high ongoing medical costs.

What Are Specifieke Zorgkosten?

Specifieke zorgkosten (specific healthcare costs) is the Dutch tax term for out-of-pocket medical expenses that exceed what your insurance covers. The idea is that people with unusually high medical costs should get tax relief.

This is a deduction from your Box 1 income — it reduces your taxable income, which in turn reduces the tax you owe.

Good to know

The Netherlands has mandatory basic health insurance (basisverzekering) that covers most standard medical care. The medical expenses deduction is designed for costs beyond what insurance covers — not as a replacement for insurance.

Which Expenses Qualify?

Eligible Medical Expenses

Category	Examples
Prescribed medications	Costs above what insurance covers (e.g., your share after insurance reimbursement)
Medical aids and devices	Hearing aids, prosthetics, wheelchairs, prescription glasses (only certain types)
Prescribed dietary expenses	Extra costs of a medically prescribed diet (fixed amounts per diet type)
Transport to medical treatment	Travel costs to hospitals, specialists, therapists (€0.23/km by car, or public transport costs)
Extra clothing and bedding costs	For people with specific medical conditions that cause excessive wear on clothing or bedding
In-home care	Costs of extra care at home due to illness or disability (not covered by Wmo or Wlz)
Mandatory own risk (eigen risico)	The mandatory deductible amount you pay before insurance covers costs (€385 in 2026)

Expenses That Do NOT Qualify

Category	Why Not
Health insurance premiums	Not deductible (the zorgtoeslag compensates for this)
Costs covered by insurance	Only the uncovered portion qualifies
Cosmetic treatments	Unless medically necessary (e.g., reconstructive surgery after an accident)
Alternative medicine	Generally not deductible unless prescribed by a registered medical professional
Gym memberships	Not deductible, even if your doctor recommends exercise
Dental care (basic)	Usually not deductible (considered normal living costs)
Contact lenses / glasses	Only deductible if prescribed for a medical condition (not routine vision correction)

Warning

The rules on what qualifies are strict and have been narrowed over the years. Always check the current Belastingdienst guidelines before claiming. Costs that seem medical to you may not meet the official criteria.

The Income Threshold

You cannot deduct all qualifying medical expenses — only the portion that exceeds an income-dependent threshold (drempel). This threshold is designed to ensure that only people with unusually high medical costs receive the deduction.

How the Threshold Works

The threshold is calculated as a percentage of your aggregate income (verzamelinkomen). For tax partners, the combined income is used.

The threshold depends on whether you have a tax partner:

Without a tax partner (all year):

Threshold Income	Threshold Calculation
€0 – €9,680	Fixed: €166
€9,681 – €51,411	1.65% of threshold income
Above €51,411	€848 + 5.75% of income above €51,411

With a tax partner (all year):

Threshold Income	Threshold Calculation
€0 – €19,360	Fixed: €332
€19,361 – €51,411	1.65% of threshold income
Above €51,411	€848 + 5.75% of income above €51,411

Worked Example

Income: €45,000 (no tax partner). Qualifying medical expenses: €3,500.

Step	Calculation
Qualifying expenses	€3,500
Threshold (1.65% × €45,000)	−€743
Deductible amount	€3,500 − €743 = €2,757
Tax saving (at 37.56%)	€1,035

If your qualifying expenses were only €500 (below the threshold), the deduction would be €0.

Prescribed Dietary Expenses

If a doctor prescribes a specific diet for a medical condition, you can deduct the extra cost of that diet. The Belastingdienst uses fixed amounts per diet type rather than actual costs:

Diet Type	Fixed Annual Deduction (2026)
Gluten-free diet (celiac disease)	€900
Energy- and protein-enriched diet	€1,050
Salt-restricted diet	€100
Diabetes diet	€0 (considered normal healthy eating)
Multiple diets combined	Combined amounts (check Belastingdienst dieetlijst 2026)

The fixed amounts are updated periodically. The full list (dieetlijst 2026) is published on the Belastingdienst website and covers dozens of diet types for specific medical conditions.

You need a written statement (verklaring) from your doctor confirming the medical necessity of the diet. The deduction is the fixed amount — not your actual spending on special food products.

Tip

The gluten-free diet deduction of €900 per year is one of the more commonly claimed dietary deductions. If you have celiac disease and a doctor's confirmation, this is straightforward to claim and can save you approximately €338 per year in tax (at the 37.56% rate).

Transport Costs

Travel costs to and from medical treatment are deductible. The rules depend on the mode of transport:

Car: €0.23 per kilometer (the standard mileage rate)
Public transport: Actual costs (keep tickets or OV-chipkaart statements)
Taxi: Actual costs if medically necessary (e.g., you cannot use public transport due to your condition)
Ambulance: Not deductible (covered by insurance)

You can claim transport for visits to doctors, specialists, hospitals, physiotherapists, and other registered medical professionals. Keep a log of your trips with dates, destinations, and distances.

Tax Partners and Medical Expenses

Medical expenses are a joint income component for tax partners. This means:

Both partners' qualifying expenses are combined into one total
The income threshold is based on the combined aggregate income
The deduction can be allocated to whichever partner benefits most

In practice, combining expenses often helps because a single higher total more easily exceeds the threshold. However, the threshold is also higher because it is based on combined income.

How to Claim the Deduction

Step 1: Gather Documentation

For each expense, you need:

Invoices or receipts showing the cost
Proof of payment (bank statements)
Evidence that insurance did not cover the cost (rejection letter or explanation of benefits)
Doctor's prescription or referral where applicable
For dietary expenses: a written statement from your doctor

Step 2: Calculate the Deductible Amount

Add up all qualifying expenses for the year
Subtract any reimbursements received (from insurance, employer, or other sources)
Subtract the income-dependent threshold
The remainder is your deductible amount

Step 3: Enter in Your Tax Return

Enter the amounts in the "Specifieke zorgkosten" section of your tax return. The Belastingdienst may ask for documentation, so keep everything for at least 7 years.

Good to know

The Belastingdienst regularly audits medical expense deductions, particularly for high amounts. Make sure you have proper documentation for every claim. Estimates and approximations are not accepted.

Special Cases

Chronic Illness or Disability

People with chronic conditions often have the highest qualifying expenses and benefit most from this deduction. Recurring costs like medical aids, transport for ongoing treatment, and prescribed diets add up over the course of a year.

Children's Medical Expenses

If you pay medical expenses for your minor children (under 18), these costs can be included in your own deduction. For adult children (18+), you generally cannot deduct their expenses.

Medical Expenses Incurred Abroad

If you receive medical treatment abroad, the costs may still be deductible — provided they would also qualify under Dutch rules. Keep extra documentation: receipts in foreign currency with exchange rates, and proof that the treatment was medically necessary.

Common Mistakes

Claiming insurance premiums as medical expenses — Health insurance premiums are not deductible. Only out-of-pocket costs beyond insurance coverage qualify.
Forgetting the income threshold — Many people add up their medical expenses and assume the full amount is deductible. Only the amount above the threshold counts.
Not keeping receipts — The Belastingdienst can ask for proof years later. Without documentation, your deduction will be denied.
Claiming non-qualifying expenses — Gym memberships, cosmetic procedures, and routine dental care generally do not qualify. Check the official list.
Not combining expenses with tax partner — Combining may help exceed the threshold. Always calculate both ways (combined vs separate).