Tax Deductions for Healthcare Costs in Switzerland

Health insurance premiums (KVG and VVG)

Health insurance premiums are deductible from your taxable income. The rules differ between federal and cantonal taxes:

• Federal tax: You can deduct KVG (basic insurance) and VVG (supplementary insurance) premiums up to a fixed maximum. For 2025, the federal deduction caps are CHF 1,800 per adult (CHF 3,600 for married couples) and CHF 700 per child if you have children. If you do not participate in a pillar 2 pension scheme, the caps are higher: CHF 2,700 per adult.
• Cantonal tax: Most cantons allow a deduction for health insurance premiums, but the amounts and rules vary significantly by canton. Some cantons allow the full premium as a deduction, others have fixed caps. Check your canton's tax guide.
• Prämienverbilligung: If you receive premium subsidies, you must subtract the subsidy from the premium amount before claiming the deduction. You only deduct the portion you actually paid yourself.

Out-of-pocket medical expenses (federal tax)

On your federal tax return, you can deduct medical expenses that you paid yourself (not reimbursed by insurance) if they exceed 5% of your net income. Only the amount above the 5% threshold is deductible.

Example: If your net income is CHF 80,000, the threshold is CHF 4,000 (5%). If your total out-of-pocket medical expenses were CHF 6,500, you can deduct CHF 2,500 (the amount exceeding the threshold).

Qualifying expenses include:

• Franchise payments: The portion of medical costs you paid toward your annual franchise (deductible)
• Selbstbehalt payments: The 10% co-payment on costs above the franchise, up to the annual cap of CHF 700 (CHF 350 for children)
• Dental costs: Dentist bills, orthodontics, and dental hygiene not covered by insurance
• Glasses and contact lenses: Prescription eyewear costs
• Medication costs: Prescription medications you paid for out of pocket (e.g., not on the Spezialitätenliste)
• Physiotherapy, psychotherapy: Out-of-pocket costs for treatments not fully covered by insurance
• Hospital costs: Any portion you paid yourself (e.g., room upgrades, non-covered treatments)
• Travel costs for medical treatment: In some cantons, transport costs to reach medical appointments can be deducted

Cantonal tax deductions for medical expenses

Cantonal rules for medical expense deductions vary widely:

• Some cantons apply the same 5% threshold as the federal tax (e.g., Zurich).
• Some cantons have a lower threshold — in some cases 2% or even no threshold at all, meaning all out-of-pocket medical expenses are deductible.
• Some cantons have different rules for what qualifies as a deductible medical expense. Check the specific tax guide (Wegleitung / guide fiscal) of your canton.

The cantonal tax authority's website typically provides a detailed list of deductible healthcare costs. If in doubt, include the expense and let the tax authority decide — they will adjust your return if it does not qualify.

Practical examples

Here are typical scenarios showing how healthcare tax deductions work:

• Single person, CHF 60,000 net income, CHF 300 franchise:
  KVG premium: CHF 4,200/year (deductible up to federal cap of CHF 1,800). Franchise paid: CHF 300. Selbstbehalt paid: CHF 450. Dental bill: CHF 1,200. Total out-of-pocket: CHF 1,950. Federal threshold: CHF 3,000 (5%). Since CHF 1,950 is below CHF 3,000, no additional federal deduction for medical expenses. But the premium deduction of CHF 1,800 still applies.
• Family (2 adults, 2 children), CHF 120,000 net income, CHF 2,500 franchise:
  KVG premiums (family): CHF 14,400/year. Franchise paid: CHF 2,500 + CHF 200 (child). Selbstbehalt: CHF 700 + CHF 350 (child). Dental: CHF 3,000. Glasses: CHF 800. Total out-of-pocket: CHF 7,550. Federal threshold: CHF 6,000 (5%). Deductible medical expenses: CHF 1,550 (amount above threshold). Plus premium deduction of CHF 3,600 (federal cap for married couple) + CHF 1,400 (2 children).

Which forms to use

On your Swiss tax return, healthcare deductions are typically entered in the following sections:

• Federal tax (Bundessteuer / impôt fédéral direct): Insurance premiums go under "Versicherungsprämien und Zinsen von Sparkapitalien" (insurance premiums and savings interest). Medical expenses go under "Krankheits- und Unfallkosten" (illness and accident costs).
• Cantonal tax: The form names and sections vary by canton but typically mirror the federal structure. Look for "Krankheitskosten" or "frais de maladie" sections.
• Online filing: If you file online (e.g., via ZHprivateTax in Zurich, VSTax in Vaud, or the federal eTax system), the software will guide you through the healthcare deductions step by step and calculate the threshold automatically.

Timing: deduct in the year paid

The general rule is that you deduct expenses in the tax year in which you actually paid them, not when the treatment occurred. For example:

• A dental treatment in December 2025 that you pay in January 2026 is deductible on your 2026 tax return.
• An invoice from October 2025 that you pay in November 2025 is deductible on your 2025 tax return.
• Insurance premiums are deducted in the year they are paid. If you pay 12 months in advance, the full amount is deductible in the year of payment.