Medical expense deduction
Eligible expenses, reimbursements, thresholds, family costs, and five-year retention.
You can deduct qualifying medical costs you paid during the year for yourself or family sharing your livelihood, minus reimbursements and a ¥100,000 threshold (or 5% of total income below ¥2M), capped at ¥2M — filed on a return with receipts kept five years.
Effective: 2026-01-01 to 2026-12-31
Professional review pending — treat as draft and confirm with the authorities.
Key points
- Formula: costs − reimbursements − ¥100,000 (or 5% of total income if below ¥2M).
- Cap: ¥2M deduction.
- Family costs count if the member shares your livelihood and you paid.
- File a statement; keep receipts five years. Requires a return (not year-end adjustment).
How it works
Add qualifying medical costs paid in the calendar year, subtract insurance and other reimbursements tied to those costs, then subtract the threshold — ¥100,000, or 5% of total income if that is below ¥2M. The result, capped at ¥2M, is your deduction. Example: ¥500,000 costs − ¥100,000 reimbursement − ¥100,000 threshold = ¥300,000 deduction.
What counts and records
Qualifying costs include treatment, prescriptions, and certain transport, for you or a family member sharing your livelihood, but only amounts actually paid (an unpaid bill does not count) and generally not cosmetic procedures. File a medical-expense statement with the return and retain receipts for five years. The deduction requires a return; it cannot be taken through year-end adjustment.
Who this is for
- Households with high medical bills
- Anyone who paid for family care
What this is not
- Cosmetic or non-medical costs
- Self-medication in the same year (alternative)
- You cannot combine the ordinary medical deduction and self-medication deduction in the same year.
Frequently asked questions
Do I need to file a tax return in Japan?
Many employees do not, because tax is settled by year-end adjustment (年末調整). You generally must file (確定申告) if you have side income over ¥200,000, two or more employers, self-employment income, sizeable investment or crypto gains, or you want to claim deductions like large medical costs or a first-year mortgage credit. Filing season is Feb 16 – Mar 15 via e-Tax. When unsure, check the NTA guidance or ask a 税理士.