My employer did the year-end adjustment. Do I still need to file?

Yes. The year-end adjustment (年末調整) does not include 医療費控除; you must file a tax return to claim it.

Can I include my spouse's and children's costs?

Yes, if they share your household finances (生計を一にする). It usually pays for the higher earner to claim.

I forgot to claim last year. Is it too late?

You can file a refund return (還付申告) within 5 years from 1 January of the year after the costs were paid.

Medical expense deduction (医療費控除) in Japan, explained

Updated: October 2026

If you and your family spend a lot on medical care in a year, you may reduce your income tax through 医療費控除. Employees whose company does the year-end adjustment (年末調整) still have to claim this themselves.

Who can claim?

It is calculated per calendar year (1 January – 31 December). If the medical costs you paid for yourself and family members who share your household finances (生計を一にする) exceed ¥100,000, you can claim. If your total income is under ¥2 million, the threshold is 5% of your income instead.

How it is calculated

Deduction = (total paid − amounts reimbursed by insurance, 高額療養費, etc.) − ¥100,000 (or 5% of income). The maximum is ¥2 million.

Example: your household paid ¥250,000 in the year with no reimbursement: ¥250,000 − ¥100,000 = ¥150,000 is deducted from taxable income. The refund depends on your tax rate, and next year's resident tax also goes down.

What counts and what does not

Counts	Does not count
Consultation, treatment, hospital stays	General health check-ups (unless an illness is found and treated)
Prescribed medicine from a pharmacy	Supplements and vitamins for prevention
Over-the-counter medicine used for treatment	Cosmetic surgery
Train and bus fares to get treatment	Petrol and parking when you drive yourself
Taxis when public transport is not possible	Taxis when you could take a train or bus
Ordinary dental treatment	Orthodontics purely for appearance

Preparing and filing

Keep receipts all yearKeep every clinic and pharmacy receipt (領収書) and note your fares to medical visits.
Prepare the statement (医療費控除の明細書)List costs by patient and by provider. You do not attach the receipts, but you must keep them for 5 years in case the tax office asks.
File a tax return (確定申告)The usual period is roughly mid-February to mid-March of the following year. A refund-only return can be filed from January and up to 5 years later. File via e-Tax, by post or at the tax office (税務署).

There is an alternative scheme for over-the-counter medicine (セルフメディケーション税制). You cannot use both in the same year; choose the better one.

How ViCare helps

ViCare's visit diary records what you paid at the clinic and the pharmacy for each visit (photograph a receipt and the form opens with the date and amount), adds up yearly totals and lets you copy them as text or CSV for your 医療費控除 statement.

Coming soon to the App Store · Coming soon to Google Play

See the ViCare app

Quick answers

My employer did the year-end adjustment. Do I still need to file?: Yes. The year-end adjustment (年末調整) does not include 医療費控除; you must file a tax return to claim it.
Can I include my spouse's and children's costs?: Yes, if they share your household finances (生計を一にする). It usually pays for the higher earner to claim.
I forgot to claim last year. Is it too late?: You can file a refund return (還付申告) within 5 years from 1 January of the year after the costs were paid.

This article is general reference information and does not replace advice from a doctor, pharmacist or public office. Rules can differ by municipality and change over time; check with your clinic or city office.