Medical Expenses Tax Deduction in the Netherlands (2026)

How does the medical expenses tax deduction in the Netherlands work?

You can deduct specific healthcare costs (specifieke zorgkosten) in your Dutch income tax return once they rise above an income-based threshold. The deduction covers costs you paid yourself because of illness or disability. Think of dental treatment, physiotherapy, prescribed medicines and travel to your doctor. Three costs never count, and they surprise many internationals: your health insurance premium, your eigen risico (the amount you pay yourself each year before insurance pays out) and certain everyday costs.

Meet Jonas. He works in Utrecht, and 2026 is an expensive care year for him: physiotherapy his insurer only partly covers, prescribed medicines and prescribed insoles. We follow his situation through this page and work his deduction out to the euro.

Which healthcare costs are deductible in 2026?

Dental care, physiotherapy, prescribed medicines, aids and care-related travel are the core deductible categories in 2026. The Belastingdienst (the Dutch tax authority) publishes one list that decides every case, and the exclusions matter as much as the deductions.³ The table below gives the answer per cost.

Some costs sit in between. Hearing aids, dentures, a paramedic without a referral and ivf treatment before age 43 are deductible under extra conditions.³ For Jonas the table is clear: his physiotherapy, medicines and insoles all land on the yes side.

When do your costs qualify?

A cost qualifies when illness made it necessary and nobody could reimburse it.⁴ You must also have paid it in the filing year. Costs your insurer or the WMO (municipal social-support act) would cover stay out, even if you never claimed them. Costs that fall under your eigen risico stay out too. Keep your invoices and bank statements for 5 years, because the Belastingdienst may ask for proof.⁴

One allowance works in your favour here. Payments you received from the CAK or the UWV do not reduce your deductible amount.⁴ The UWV is the Dutch employee insurance agency. Neither does the Tegemoetkoming specifieke zorgkosten (a state top-up for high care costs).⁴ Jonas felt this rule directly: his insurer reimbursed part of his physiotherapy, so only the part he paid himself counts.

How high is the threshold (drempel) in 2026?

Your threshold follows your drempelinkomen and is €166 at the lowest incomes.¹ You only deduct the part of your specifieke zorgkosten above it. The income that sets your threshold is your total income in boxes 1, 2 and 3 before personal deductions. The Belastingdienst calls that measure your drempelinkomen. Did you have a fiscal partner for the whole year? Then you add your costs and both drempelinkomens together. The joint total sets one threshold for you both.¹

What is the verhoging specifieke zorgkosten?

The verhoging is an increase: with a lower income you may deduct more than you actually paid. Is your drempelinkomen €41,123 or lower in 2026 (the joint figure if you have a full-year fiscal partner)? Then you raise most specifieke zorgkosten by 40% before applying the threshold.² Have you reached AOW age (state pension age) on 1 January 2026? The increase becomes 113%. When one partner has reached AOW age, both of you use the high percentage.²

The increase skips two categories: medical treatment (genees- en heelkundige hulp) and sick-visit travel.² So Jonas's physiotherapy stays at its invoice amount, while his medicines and insoles grow by 40%.

Are diet costs deductible in the Netherlands?

Yes. A prescribed diet is deductible at a fixed amount from the Belastingdienst diet list (dieetlijst).⁹ You do not collect supermarket receipts for this. The list pairs a condition with a diet type. Each pair carries one fixed amount, and that amount goes in your return.⁹

Two conditions decide your case. A doctor or dietitian must have prescribed the diet. And your condition with its diet type must appear on the dieetlijst for the year you file.⁹ A new list appears every year and the amounts move with it. Use the list for your filing year, not the current one.

The spread is wide. It runs from €50 for a strongly salt-restricted diet with nephrotic syndrome up to €4,100 for a strongly protein-restricted diet with PKU.⁹ The table below holds the diets we see most.

The Belastingdienst can ask you for a dieetbevestiging, a short confirmation your doctor or dietitian fills in.¹⁰ You only send it when they ask for it. There is a separate form per year, so make sure you can get one for the year you are filing.¹⁰

Diet costs are specifieke zorgkosten like any other. They count towards your threshold, and the verhoging raises them when your drempelinkomen allows it.²

Can you deduct travel costs for care?

Yes. Trips to the doctor, hospital or pharmacy are deductible at the actual cost you paid.³ Higher transport costs caused by illness or disability count as well, above what people in a comparable position normally spend.³

Visiting a sick family member follows its own rule, the reiskosten ziekenbezoek (travel to visit someone who is ill).⁵ You deduct €0.25 per kilometre by car in 2026, or the actual cost by taxi or public transport. Parking, ferry and toll charges count from 2025 onwards. Four conditions apply: you shared a household when the care started, you visit regularly, the care lasts longer than a month, and the single trip is more than 10 kilometres.⁵

Whose healthcare costs can you deduct?

Your own costs, your fiscal partner's and those of children younger than 27 who cannot cover the costs themselves.⁶ The circle is wider than most people expect. Costs also count for a severely disabled housemate of 27 or older.⁶ The condition is that they qualify for admission under the Wlz (the long-term care act).⁶ Care-dependent parents or siblings who live with you count too.⁶

Are healthcare costs abroad deductible?

Yes. Treatment abroad is deductible under the same conditions as treatment in the Netherlands.⁴ Travel costs count too, as long as the trip serves only the treatment. Hotel and other stay costs before, during or after the treatment never count.⁴

That answer matters for internationals more than the Belastingdienst pages let on. Planned dental work or a specialist visit in your home country lands in your Dutch return like any Dutch invoice. The conditions above still decide the case. Did you arrive in the Netherlands during 2026? Then your arrival date decides which costs count, so check that first. Ask us which months count if you arrived or left during 2026.

How much can Jonas deduct? The full calculation

Jonas deducts €388 in 2026. The list, the increase and the threshold come together in three steps. First you total the deductible costs. Then you apply the verhoging to the costs that qualify for it. Finally you subtract your threshold. Jonas has a drempelinkomen of €36,000 and no fiscal partner. His costs run through the table below.

Jonas enters €388 as a deduction in his 2026 return. It lowers his taxable income, so part of it comes back through his assessment. His numbers show how the mechanism works, they are not a promise of your own result. Menno van der Made, tax advisor at TaxSavers, sees most doubt at exactly this step.

What does this mean for your tax return?

Gather your care invoices, subtract every reimbursement and check your total against your threshold. That is the whole job. Count the costs for your partner and children in. Apply the verhoging if your drempelinkomen allows it. Then enter the outcome in your return.

Two follow-ups are worth knowing. Is your income low and your deduction granted? The Belastingdienst pays the Tegemoetkoming specifieke zorgkosten automatically after your assessment, you do not apply for it.⁷ And are you filing your 2025 return now? Slightly lower figures apply. The threshold starts at €164 and the verhoging limit is €40,502.⁸ The 1.65% band runs to a drempelinkomen of €50,635.⁸

Healthcare costs are one of several deductions in the Dutch system. You can read how they all fit together in our guide to tax deductions in the Netherlands. Buying a house this year? We explain which notary costs are deductible too. And prefer your refund monthly instead of once a year? You can arrange that with a provisional assessment (voorlopige aanslag).