Health expenses can be easy to overlook or overclaim. The key is establishing what qualifies, who recommended the treatment and whether another reimbursement is available first.

Health expenses are one of the areas where relatively small details can change the tax treatment.

In a recent webinar, Health Expenses: Are they eligible for tax relief, Naomi Butler explained that some clients include expenses that do not qualify. Others miss legitimate claims because they assume everyday healthcare costs cannot attract relief. There is also a wider question accountants should consider: is tax relief actually the most valuable route available?

Revenue's updated guidance puts particular emphasis on the circumstances surrounding an expense and the involvement of a medical practitioner. That makes the supporting evidence increasingly important.

Here are the practical points to consider when reviewing a client's health expenses.

1. Start with what counts as healthcare

Section 469 TCA provides relief for qualifying health expenses incurred in providing healthcare.

As discussed during the webinar, healthcare can cover the prevention, diagnosis, alleviation or treatment of an ailment, injury, infirmity, defect or disability. It also encompasses care connected with pregnancy and routine maternity care.

That definition covers a wide range of expenditure, but it does not make every health-related cost allowable.

Routine eye tests, glasses and contact lenses were highlighted as examples that generally do not qualify for this relief. Routine dental treatment, including procedures such as fillings, extractions and scaling, was also distinguished from qualifying non-routine dental treatment.

Cosmetic treatment requires particular care. The webinar explained that treatment undertaken purely for cosmetic reasons is treated differently from procedures required because of an abnormality, injury, disease or other qualifying health issue.

The practical lesson is simple: do not decide eligibility from the name of the treatment alone. Establish why the expense arose and the circumstances in which the treatment was provided.

2. Ask who recommended or prescribed the treatment

One recurring theme throughout the session was the importance of treatment being connected with an appropriate practitioner.

This can become particularly relevant with physiotherapy and similar treatments.

A client who independently decides to visit a physiotherapist may be in a different position from somebody receiving treatment following medical advice or referral. The same issue can arise with other treatments and medical appliances.

That makes the client conversation important.

Rather than simply recording "physio €500", establish why the treatment was required and whether there is supporting medical evidence.

Where eligibility could be challenged, retaining written evidence from the relevant practitioner can make the position considerably clearer.

3. Look beyond the tax return

Getting 20% tax relief on an expense may not be the client's best available outcome.

Before making a tax claim, establish whether some or all of the expense can be recovered elsewhere.

Private health insurance is an obvious example. Where an insurer reimburses part of a qualifying expense, the tax claim should relate to the appropriate unreimbursed amount rather than treating the original gross cost as wholly borne by the taxpayer.

The webinar also highlighted situations where another support scheme could be more valuable.

For example, a client's circumstances may warrant checking eligibility for relevant healthcare schemes rather than simply accepting recurring medication costs as an annual tax-relief claim.

This is where accountants can add value by looking beyond the individual receipt.

Ask:

• Has an insurer reimbursed any of this expense?
• Is another healthcare scheme potentially relevant?
• Has somebody else already claimed reimbursement or relief?
• Are there additional tax credits or provisions connected with the client's circumstances?

The objective is not simply to maximise the health-expenses box. It is to understand the client's overall position.

4. Watch for expenses involving spouses and family members

Health expenses should not automatically be reviewed in isolation for each person.

The webinar highlighted the risk of spouses making separate claims without telling each other or their accountant. That can create problems where relief has already been received.

Family circumstances can also reveal other issues worth examining.

A serious illness or disability, for example, may make other tax provisions relevant. Where somebody requires ongoing care, there may also be tax, payroll or administrative considerations beyond the original medical expense.

These conversations can be sensitive. Accountants do not need unnecessary medical detail, but they do need enough information to identify the appropriate tax treatment.

5. Keep evidence even when it is not requested immediately

Record-keeping matters because Revenue can subsequently seek evidence supporting a claim.

The webinar distinguished between different claiming routes and discussed Revenue's Receipts Tracker and real-time claims through myAccount.

Whatever route applies, maintaining clear records remains sensible.

Keep copies of invoices and receipts, together with relevant reimbursement statements. Where treatment depends upon medical recommendation or prescription, retain supporting documentation where appropriate.

That documentation can be particularly useful where an insurer refuses reimbursement because a particular policy does not cover an expense. An insurer declining a payment does not, by itself, establish whether an expense qualifies for tax relief.

6. Treatment outside Ireland requires an extra question

Overseas medical treatment is another area where circumstances matter.

The webinar drew an important distinction between treatment that a patient must obtain outside Ireland and treatment that they simply choose to receive abroad.

That distinction can affect associated travel and accommodation costs.

For accountants, this means an overseas medical invoice should prompt further questions. Establish why the patient travelled, who provided the treatment and which associated expenses were necessarily incurred.

Do not assume that flights and accommodation qualify simply because the underlying medical procedure does.

7. Some less obvious costs may qualify

One reason clients underclaim is that they do not always recognise an expense as potentially eligible.

The webinar discussed examples including certain medical appliances, hearing aids, qualifying specialised dental treatment, IVF and other assisted human reproduction treatment, and qualifying costs associated with assistance dogs.

It also covered specific provisions that can apply in particular circumstances, including certain expenses associated with serious illness and particular dietary products for people with specified medical conditions.

These examples reinforce the value of asking clients for a proper breakdown rather than accepting one annual total labelled "medical".

However, eligibility can depend on detailed conditions. Unusual expenses should therefore be checked against the current Revenue guidance before being included.

8. Pharmacy services are an area to watch in 2026

The webinar also discussed Ireland's Common Conditions Service, introduced in 2026, under which participating community pharmacists can provide consultations and treatment options for specified conditions.

This creates an important tax question because traditional health-expense rules place considerable weight on the role of the medical practitioner.

The session indicated that tax relief may apply to qualifying expenditure under the service from January 2026, pending the relevant legislative position.

The practical takeaway

Health-expense claims should not become a year-end exercise in adding receipts together.

For each material or unusual expense, establish what was provided, why it was required, who recommended or prescribed it, who actually paid for it and whether any reimbursement has already been received.

That approach can help identify valid claims that clients might otherwise miss. It can also reduce the risk of submitting expenditure that does not meet Revenue's conditions.

Most importantly, consider the client's wider circumstances. Sometimes the useful tax advice begins with a medical receipt but ends somewhere else entirely.

Frequently Asked Questions

What health expenses qualify for tax relief in Ireland?

Qualifying health expenses can include costs connected with the prevention, diagnosis, alleviation or treatment of an ailment, injury, infirmity, defect or disability. Pregnancy and routine maternity care can also fall within healthcare provisions.

Eligibility depends on the expense and the circumstances in which treatment was provided. Routine eye care, routine dental treatment and purely cosmetic procedures were highlighted in the webinar as areas where restrictions apply.

What rate of tax relief applies to health expenses?

The webinar generally discussed health expenses in the context of relief at 20%, while noting that particular categories can receive different treatment.

Accountants should therefore avoid assuming every health-related expense receives identical relief. The applicable rate and conditions should be checked against current Revenue guidance, particularly for less common expenses or circumstances.

Do routine dental expenses qualify for tax relief?

Routine dental treatment was identified in the webinar as not qualifying for health-expense tax relief. Examples discussed included extractions, scaling and fillings.

Certain non-routine or specialised dental treatments can qualify. The webinar gave root canal treatment as one example. Clients should obtain the appropriate supporting documentation and check that the particular treatment meets Revenue's current requirements.

Can you claim tax relief on glasses or contact lenses?

Routine eye tests, glasses and contact lenses were identified in the webinar as expenses that do not generally qualify for health-expense tax relief.

This does not mean every form of eye treatment is excluded. Medical treatment for an eye condition can be treated differently from routine optical care. The nature and purpose of the treatment therefore need to be established before making a claim.

Can you claim tax relief on physiotherapy in Ireland?

Physiotherapy may qualify, but the circumstances in which treatment is obtained matter.

A major theme of the webinar was Revenue's emphasis on treatment connected with an appropriate medical practitioner. Self-referral to a physiotherapist was distinguished from treatment undertaken following medical advice, prescription or referral. Accountants should retain evidence supporting the medical basis for treatment where appropriate.

Can gym or swimming-pool membership qualify as a health expense?

The webinar discussed a case where a GP had advised a patient with arthritis and mobility problems to swim and exercise regularly. The speaker considered there to be an argument for relief because the activity was undertaken following medical advice rather than simply for recreation.

Do hearing aids qualify for tax relief?

Hearing aids were included among the examples of allowable medical appliances discussed during the webinar. However, the broader guidance emphasised that medical appliances should be supplied, maintained or repaired for use on the advice of an appropriate practitioner.

Clients should therefore retain evidence supporting both the expense and its medical basis rather than assuming every hearing-related purchase qualifies.

Can you claim tax relief on IVF treatment?

The webinar identified IVF and other forms of assisted human reproduction treatment among expenses that can qualify for health-expense tax relief.

Because treatment can involve several separate costs, clients should retain detailed invoices and records of any reimbursements. Each component should be considered against Revenue's current rules rather than assuming every associated cost automatically qualifies.

Can cosmetic surgery qualify for tax relief?

Purely cosmetic procedures generally do not qualify. However, the webinar explained that treatment may be treated differently where it is necessary because of a physical deformity arising from, or directly related to, an abnormality, personal injury or disfiguring disease.

The purpose and medical necessity of the procedure therefore matter. Supporting medical evidence may be particularly important where a treatment could otherwise appear cosmetic.

Can medical treatment outside Ireland qualify for tax relief?

Medical treatment received outside Ireland can potentially qualify, provided the relevant conditions are satisfied.

The webinar distinguished between treatment that is only obtainable outside Ireland and treatment that a patient chooses to obtain abroad. That distinction can affect whether associated travel and accommodation costs qualify. The status of the overseas practitioner and treatment provider can also be relevant.

Can travel and accommodation for medical treatment be claimed?

Certain travel and accommodation expenses may qualify where they are necessarily incurred in obtaining healthcare, according to the webinar.

The treatment circumstances are important. Regular or necessary long-distance travel can be treated differently from minor local or occasional journeys. Different considerations can also apply to overseas treatment and to a person who must accompany a patient.

Should clients claim from their health insurer before claiming tax relief?

Where an expense can be reimbursed through private health insurance, the webinar recommended dealing with that reimbursement before calculating the tax-relief claim.

Tax relief should not be claimed as though the taxpayer bore an expense that has already been reimbursed. Accountants should establish the original expense, insurance reimbursement and remaining amount actually borne by the taxpayer before preparing the claim.

Can an expense qualify for tax relief if a health insurer refuses to reimburse it?

Potentially. An insurer refusing an expense does not necessarily establish its tax treatment.

The webinar noted that an expense might be excluded simply because a client's particular insurance policy does not cover it. Eligibility for tax relief should therefore be considered separately against Revenue's rules. Clients should retain the original receipt and any relevant supporting medical evidence.

Can you claim health expenses for your spouse or children?

The webinar stressed that accountants should consider health expenses across the wider family rather than automatically reviewing each person's expenses separately.

It also highlighted the need to check whether a spouse has already submitted a claim. Duplicate relief should not be claimed. Family medical circumstances may also indicate that other tax credits, healthcare schemes or supports need to be considered.

Do you need receipts to claim health-expense tax relief?

Receipts and supporting evidence should be retained because Revenue may request them when checking a claim.

The webinar also discussed different requirements for claims through myAccount, the Receipts Tracker and tax returns. Because those administrative requirements can change, the precise current rules should be checked before publication rather than assuming the same process applies to every taxpayer.

How long should health-expense receipts be kept?

The webinar advised retaining health-expense receipts for six years and keeping clear copies where originals are supplied elsewhere, such as to a health insurer.

Can prescribed medicines qualify for tax relief?

The webinar identified drugs and medicines prescribed by a doctor, dentist or consultant as potentially qualifying health expenses.

It also discussed the interaction between tax relief, the Drugs Payment Scheme and other healthcare supports. Accountants should first establish whether another reimbursement or healthcare scheme applies before treating the full medication cost as a tax-relief claim.

Can gluten-free food qualify for tax relief for someone with coeliac disease?

The webinar stated that certain foods specifically manufactured to be gluten-free for coeliac patients can qualify, with receipts used to support expenditure.

It also noted that some supermarkets may provide annual purchase summaries, making record-keeping easier. Ordinary food expenditure should not automatically be treated as qualifying simply because somebody follows a gluten-free diet.

Can assistance-dog expenses qualify for tax relief?

The webinar discussed tax relief for qualifying assistance dogs, including dogs supporting certain children with autism. It emphasised that conditions apply to the organisation supplying and training the dog.

The session also discussed different methods of claiming associated expenditure. The eligibility conditions and any current flat-rate amount should be checked before making or publishing a specific claim.

What should accountants check before claiming a client's health expenses?

Start by establishing what the expense was, why it was incurred and who recommended or prescribed the treatment. Then check who actually paid the expense and whether private insurance or another scheme has already reimbursed any amount.

Finally, retain appropriate receipts and medical evidence. Unusual expenses should be checked against current Revenue guidance rather than relying solely on the description appearing on the receipt.

The contents of this article are meant as a guide only and are not a substitute for professional advice. The authors accept no responsibility for any action taken, or refrained from, as a result of the material contained in this document. Specific advice should be obtained before acting or refraining from acting, in connection with the matters dealt with in this article.