How much will I get back from the medical expense deduction?

As a rough guide, you get back income tax equal to the deduction multiplied by your income tax rate, plus resident tax of 10% of the deduction (as a reduction). For a single employee with 300,000 yen of medical expenses, it is 30,210 yen at an income of 3 million yen, 40,420 yen at 5 million yen (20,420 yen income tax and 20,000 yen resident tax), and 60,840 yen at 8 million yen.

Can I use the medical expense deduction if my medical expenses are under 100,000 yen?

Yes, if your total income is under 2 million yen. In that case, the amount over 5% of your total income is deducted instead of 100,000 yen. For example, an employee earning 1.5 million yen has a total income of 850,000 yen, so the threshold is 42,500 yen. With 100,000 yen of medical expenses, 57,500 yen is deducted and the resident tax drops by 5,800 yen; with 300,000 yen of medical expenses, the resident tax drops by 19,800 yen.

Which spouse should file the medical expense deduction?

Usually the one with the higher income tax rate (higher income) benefits more. With 300,000 yen of medical expenses, a husband earning 6 million yen gets back 40,420 yen, while a wife earning 1.5 million yen has a lower threshold of 42,500 yen but pays no income tax, so only her resident tax drops, by 19,800 yen. You can compare by entering each family member's income on the "Who should file?" tab.

Which is better, the medical expense deduction or the Self-Medication Tax System?

Whichever gives the larger deduction. With an income of 5 million yen and total medical expenses of 120,000 yen (of which 50,000 yen is eligible over-the-counter drugs), the medical expense deduction is 20,000 yen and returns 4,042 yen, while the Self-Medication Tax System has a deduction of 38,000 yen and returns 7,680 yen, so the Self-Medication Tax System is better. In a year when medical expenses well exceed the threshold, the medical expense deduction is better.

How much does the medical expense deduction reduce my resident tax?

About 10% of the deduction. If the deduction is 200,000 yen, resident tax drops by about 20,000 yen. Resident tax is not refunded; it is reflected as a reduction in your resident tax from June of the year after you file your tax return.

How do I calculate when I received insurance payments?

Hospitalization benefits from life insurance, high-cost medical care benefits from health insurance, the lump-sum childbirth allowance and similar amounts are subtracted from the medical expenses you paid. With 500,000 yen of medical expenses and 200,000 yen of insurance, the deduction is 300,000 yen minus the threshold. However, the reimbursed amount is subtracted only from the medical expenses it covered, not from other expenses.

What expenses are eligible for the medical expense deduction?

Eligible expenses include doctor visits and hospital stays, prescription drugs, over-the-counter drugs for treatment, train and bus fares to the hospital, dental treatment (including implants), childbirth costs, fertility treatment, and acupuncture, moxibustion and massage for treatment. Vaccinations, health checkups (when no illness is found), supplements, cosmetic treatments and gasoline for a private car are not eligible. You can check each item on the "Check eligibility" tab.

Are taxi fares to the hospital eligible for the medical expense deduction?

Taxi fares are eligible when you cannot use trains or buses, such as when you cannot walk because of a sudden illness or injury. Taxi fares used simply for convenience are not eligible. A taxi taken to the hospital for childbirth, for example because of labor pains, is eligible.

By when do I need to file a tax return for the medical expense deduction?

If you are an employee or someone else not required to file and you file only for the medical expense deduction, it is a "refund return" and can be filed for five years starting January 1 of the following year. For the 2025 tax year, the deadline is December 31, 2030. You need a "statement of medical expenses" based on your receipts, and a medical expense notice (iryohi no oshirase) can also be used.

Can I get the medical expense deduction through year-end adjustment?

No. The medical expense deduction and the Self-Medication Tax System apply only if you file a tax return. Even an employee who had year-end adjustment gets back part of the withheld income tax by filing a return.

Medical Expense Deduction (Iryohi Koujo) Refund Calculator | How Much Do You Get Back? Self-Medication Tax System Comparison

Just enter the medical expenses you paid during the year, the amount reimbursed by insurance and the like, and your annual income (or the figures from your withholding slip) to calculate the medical expense deduction and the income tax you get back plus the resident tax that is reduced next year. It handles the case where the threshold is lower than 100,000 yen for income under 2 million yen, and the 2 million yen cap. You can compare it with the Self-Medication Tax System for over-the-counter drugs, see which family member should file jointly to get the most back, and use the quick-reference table by income and medical expenses and the list for checking whether taxi fares, orthodontics, glasses and so on qualify.

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About Medical Expense Deduction (Iryohi Koujo) Refund Calculator | How Much Do You Get Back? Self-Medication Tax System Comparison

The Medical Expense Deduction Refund Calculator works out how much tax you get back from the medical expense deduction (iryohi koujo) based on the medical expenses you paid during the year and your income. The deduction is (medical expenses paid minus amounts reimbursed by insurance and the like) minus 100,000 yen; people whose total income is under 2 million yen subtract 5% of their total income instead of 100,000 yen. What you get back is not the deduction itself but the income tax reduced by the deduction (refunded through the tax return) plus the next year's resident tax reduction, and it varies with your income tax rate. You can also check whether the Self-Medication Tax System for over-the-counter drugs is better for you, which family member should file to get the most back, and which expenses are eligible.

How to use Medical Expense Deduction (Iryohi Koujo) Refund Calculator | How Much Do You Get Back? Self-Medication Tax System Comparison

1Enter the total medical expenses you paid during the year (January 1 to December 31). You may combine those of family members you share living costs with.
2Enter any amounts that were reimbursed, such as hospitalization benefits from life insurance, high-cost medical care benefits, or the lump-sum childbirth allowance.
3Enter the income of the person who will file. If you have a withholding slip, entering the "amount after employment income deduction" and the "total income deductions" gives a more accurate result.
4Check the total tax you get back (income tax refund plus resident tax reduction) and the breakdown of the calculation.
5If you buy a lot of over-the-counter drugs, enter your purchases of eligible drugs and compare with the Self-Medication Tax System.
6On the "Who should file?" tab, enter each family member's income and see who gets back the most.

Great for

Find out how much you would get back from the medical expense deduction before filing your tax return
Check whether you can use the deduction even though your medical expenses are under 100,000 yen because your income is low
Estimate the refund for a year with high medical costs from childbirth, hospitalization, dental treatment and so on
Compare which spouse should claim the medical expense deduction in a dual-income couple
Decide between the medical expense deduction and the Self-Medication Tax System
Check whether taxi fares to the hospital, orthodontics, glasses and similar expenses qualify
Find out how much your resident tax will be reduced
Compare refund amounts for combinations of income and medical expenses in a quick-reference table

Good to know

The deduction is (medical expenses paid minus amounts reimbursed by insurance and the like) minus 100,000 yen (or 5% of total income if it is under 2 million yen), capped at 2 million yen (Article 73 of the Income Tax Act). For an employee, total income is under 2 million yen when the annual salary is under about 2.97 million yen.
As a rough guide, the amount you get back is the income tax (deduction x income tax rate) plus the resident tax (deduction x 10%). This tool calculates the difference in tax before and after applying the deduction, so cases where the deduction crosses a tax bracket are reflected. The income tax includes the special reconstruction income tax (2.1%).
Resident tax is not returned in cash; instead it is reflected as a reduction in your resident tax from June of the year after you file your tax return.
Reimbursed amounts are deducted only from the medical expenses that the insurance payment covered. Even if a hospitalization benefit exceeds the hospital bill, it is not subtracted from other medical expenses. This tool subtracts the total, so if a reimbursement exceeds a particular expense, enter only up to that expense as the reimbursed amount.
The Self-Medication Tax System is a special rule that deducts the portion of purchases of eligible drugs (over-the-counter drugs with an identification mark) exceeding 12,000 yen, up to 88,000 yen. You can choose only one of it or the medical expense deduction, and you must have had a health checkup, vaccination or similar that year.
Medical expenses of a spouse, children or parents you share living costs with can be filed together by one person. In general, the higher the tax rate (the higher the income) of the filer, the more you get back.
"From annual income" assumes the salary income of an employee, estimates social insurance premiums using the Kyokai Kenpo (Tokyo) rate, 18.3% for employees' pension and employment insurance, and uses the basic deduction amounts from the 2025 tax year onward. It does not include resident tax adjustment credits or the relationship with tax credits such as the housing loan deduction.
Everything you enter is calculated in your browser and is never sent to a server.

Questions this tool answers

Use Medical Expense Deduction (Iryohi Koujo) Refund Calculator | How Much Do You Get Back? Self-Medication Tax System Comparison for searches like these:

I want to calculate how much the medical expense deduction returns
I want to know my medical expense deduction refund from my income
I want to know if I can use the medical expense deduction with under 100,000 yen of medical expenses
I want to know how much resident tax the medical expense deduction reduces
I want to know which spouse should file the medical expense deduction
I want to know whether the medical expense deduction or the Self-Medication Tax System is better
I want to see a list of expenses eligible for the medical expense deduction
I want to know if taxi fares to the hospital are eligible for the medical expense deduction
I want to know if orthodontics are eligible for the medical expense deduction
I want to see a quick-reference table of medical expense deduction refunds by income

FAQ

How much will I get back from the medical expense deduction?: As a rough guide, you get back income tax equal to the deduction multiplied by your income tax rate, plus resident tax of 10% of the deduction (as a reduction). For a single employee with 300,000 yen of medical expenses, it is 30,210 yen at an income of 3 million yen, 40,420 yen at 5 million yen (20,420 yen income tax and 20,000 yen resident tax), and 60,840 yen at 8 million yen.
Can I use the medical expense deduction if my medical expenses are under 100,000 yen?: Yes, if your total income is under 2 million yen. In that case, the amount over 5% of your total income is deducted instead of 100,000 yen. For example, an employee earning 1.5 million yen has a total income of 850,000 yen, so the threshold is 42,500 yen. With 100,000 yen of medical expenses, 57,500 yen is deducted and the resident tax drops by 5,800 yen; with 300,000 yen of medical expenses, the resident tax drops by 19,800 yen.
Which spouse should file the medical expense deduction?: Usually the one with the higher income tax rate (higher income) benefits more. With 300,000 yen of medical expenses, a husband earning 6 million yen gets back 40,420 yen, while a wife earning 1.5 million yen has a lower threshold of 42,500 yen but pays no income tax, so only her resident tax drops, by 19,800 yen. You can compare by entering each family member's income on the "Who should file?" tab.
Which is better, the medical expense deduction or the Self-Medication Tax System?: Whichever gives the larger deduction. With an income of 5 million yen and total medical expenses of 120,000 yen (of which 50,000 yen is eligible over-the-counter drugs), the medical expense deduction is 20,000 yen and returns 4,042 yen, while the Self-Medication Tax System has a deduction of 38,000 yen and returns 7,680 yen, so the Self-Medication Tax System is better. In a year when medical expenses well exceed the threshold, the medical expense deduction is better.
How much does the medical expense deduction reduce my resident tax?: About 10% of the deduction. If the deduction is 200,000 yen, resident tax drops by about 20,000 yen. Resident tax is not refunded; it is reflected as a reduction in your resident tax from June of the year after you file your tax return.
How do I calculate when I received insurance payments?: Hospitalization benefits from life insurance, high-cost medical care benefits from health insurance, the lump-sum childbirth allowance and similar amounts are subtracted from the medical expenses you paid. With 500,000 yen of medical expenses and 200,000 yen of insurance, the deduction is 300,000 yen minus the threshold. However, the reimbursed amount is subtracted only from the medical expenses it covered, not from other expenses.
What expenses are eligible for the medical expense deduction?: Eligible expenses include doctor visits and hospital stays, prescription drugs, over-the-counter drugs for treatment, train and bus fares to the hospital, dental treatment (including implants), childbirth costs, fertility treatment, and acupuncture, moxibustion and massage for treatment. Vaccinations, health checkups (when no illness is found), supplements, cosmetic treatments and gasoline for a private car are not eligible. You can check each item on the "Check eligibility" tab.
Are taxi fares to the hospital eligible for the medical expense deduction?: Taxi fares are eligible when you cannot use trains or buses, such as when you cannot walk because of a sudden illness or injury. Taxi fares used simply for convenience are not eligible. A taxi taken to the hospital for childbirth, for example because of labor pains, is eligible.
By when do I need to file a tax return for the medical expense deduction?: If you are an employee or someone else not required to file and you file only for the medical expense deduction, it is a "refund return" and can be filed for five years starting January 1 of the following year. For the 2025 tax year, the deadline is December 31, 2030. You need a "statement of medical expenses" based on your receipts, and a medical expense notice (iryohi no oshirase) can also be used.
Can I get the medical expense deduction through year-end adjustment?: No. The medical expense deduction and the Self-Medication Tax System apply only if you file a tax return. Even an employee who had year-end adjustment gets back part of the withheld income tax by filing a return.

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