Medical expenses deductions

How are medical expenses deductions calculated?

When is the filing period for final tax returns?

The filing period for a final tax return is the one-month period from February 16 through March 15. However, if you earn salary income, you can apply for reimbursement of medical expenses deductions or other amounts from January.

What documents are needed to file a final tax return?

Documents and other required items include the final tax return form (which can be prepared at the National Tax Agency website), your certificate of income and withholding tax, your official seal, your deposit passbook for the account into which you wish to receive your reimbursement, and your Social Security and Tax Number card (or, if you do not have a Social Security and Tax Number card, a document that can be used to confirm your Social Security and Tax Number and your identity).
Previously, to claim medical expenses deductions, including deductions under the self-medication tax system, you needed to attach or present receipts for the medical care costs or drugs.
Starting with final tax returns filed for 2017 income, you must attach details of medical care costs or details of drug costs when filing your final tax return instead of attaching or presenting receipts.*1
In general, you are required to retain receipts for medical care and other costs related to final tax returns for five years after the deadline for filing the final tax return in question. However, you do not need to retain these receipts if you attached medical care cost information that satisfies certain conditions*2 issued by a health insurance society or similar party. Even in the latter case, you are required to retain receipts if you corrected the details of medical care costs yourself (for example, because you received public assistance for medical care costs) or if the medical care cost information attached do not provide information for certain months.

*1： This applies for those filing final tax returns for 2017 and after on January 1, 2018, or later. (As a transitional measure, you can attach or present receipts instead of submitting details of medical care costs, etc. for the years 2017–2019.)
*2 ：Applies only to medical care cost information covering the following items:

1. ① Name of the insured person or dependent
2. ② Year and month in which medical care was received
3. ③ Name of the person receiving medical care
4. ④ Name of the hospital, clinic, pharmacy, or other institution where medical care was received
5. ⑤ Amount of medical care costs paid by the insured person or dependent
6. ⑥ Name of the insurer

Examples of costs eligible for medical expenses deductions

• Costs of treatment paid to a medical care institution
• Cost of purchase of drugs for treatment
• Costs of going to the hospital, house-call costs
• Share of inpatient meal and living expenses you paid
• Costs of dental care not covered by insurance
• Costs of medical consultations from pregnancy through after childbirth and childbirth expenses
• Costs of massage, acupressure therapy, acupuncture, and moxibustion
• Costs of purchase of artificial arms, artificial legs, etc.
• Costs of adult diapers for a person bedridden for six months or longer, with a certificate from a doctor
• Costs of use of health promotion centers involving use of hot springs or exercise, with a doctor's instruction and certificate
• Costs of use of visiting nurse stations
• Costs of use of health services facilities for the aged and convalescent facilities (patient cost-sharing for long-term care expenses, meal expenses, and accommodation expenses)
• One-half of patient cost-sharing for long-term care expenses, meal expenses, and accommodation expenses at special nursing homes for the elderly
• Patient cost-sharing for long-term care expenses when receiving long-term care services at home together with medical care services based on a service plan for persons identified as needing long-term care
• Costs of specified health diagnoses and specified health guidance for persons eligible for certain active support services as part of specified health guidance

The self-medication tax system (deduction for Rx-to-OTC switch drugs) [special exception for medical expense deductions]

On an exceptional basis during the period from January 1, 2017 through December 31, 2026, if an insured person, family member, or other covered party purchases a total of more than 12,000 yen in Rx-to-OTC switch drugs (i.e., OTC drugs selected to take the place of drugs for which a prescription is required), he or she may deduct from his or her gross income for the year the amount of such costs in excess of 12,000 yen (up to a maximum of 88,000 yen). To be eligible for this deduction, you must have undergone at least one of the following: Specified health diagnosis, vaccination, periodic health examination, health screening, cancer screening
You cannot combine this special deduction for Rx-to-OTC switch drugs and ordinary medical expense deductions. Eligible persons must choose whether to use the deduction for Rx-to-OTC switch drugs or ordinary medical expense deductions.
(Specific procedures and other details have yet to be determined at this time.)

Reference link

See here for details.