Medical expenses deduction 730: how to get 19% of your treatment costs back

What the medical expenses deduction is

Every morning Sandra opens her pill box and throws the old receipts away. She used to keep them all in an envelope, but she never really knew what they were for. Then one Thursday she came to our advice office in Cinisello Balsamo, on Via Oreste Terenghi, and discovered those receipts were worth more than she imagined: the medical costs you pay during the year are claimed back through the 730 form, and part of the money you spent comes back to you.

The medical expenses deduction is a tax refund for anyone who pays for doctor's visits, medicines, tests, dental care, glasses and therapies. It is not a bonus reserved for a few: it belongs to anyone who has these costs, including for a child or a parent they support. It is called a deduction because no separate cheque arrives — it simply reduces the tax you owe. If you spent a lot on treatment last year, your 730 can come out in credit.

How much you get back: the threshold and the maths

The 129.11 euro threshold

The threshold is taken off once a year, from the total of all your medical costs. It is not 129.11 euros per receipt: it is 129.11 euros on everything added together. If in 2025 you spent 100 euros in total on medicines and visits, that stays below the line and brings back nothing. If you spent 500, the calculation starts from 500 minus 129.11.

An example with real numbers

Say that in 2025 you paid 1,500 euros in total for specialist visits, medicines and an MRI scan. Take off the threshold: 1,500 − 129.11 = 1,370.89 euros. On that figure you calculate 19%: the deduction is about 260.47 euros. It does not arrive as a separate payment: those 260.47 euros reduce the tax you owe, and if the tax you have already paid is higher, the difference comes back through your payslip or pension.

• Annual threshold: 129.11 euros, taken off once from the total of ordinary medical expenses.
• Ceiling for illnesses exempt from the ticket: 6,197.48 euros a year; the part above it cannot be claimed this way.
• 15,493.71 euro level: if your total health costs go above it, you can choose to recover the deduction in four equal yearly instalments. The choice is made in the return for the year you spent, and it cannot be changed afterwards.
• Watch out: the 15,493.71 euro level is calculated before the threshold, on the total you spent, not on what is left after removing the 129.11 euros.

Which medical expenses qualify for the 730

Not all health costs look the same to the tax office. The ones that earn the 19% deduction are general medical expenses and specific care, plus specialist treatments. Here is what counts in practice:

• Visits to your family doctor and private specialist consultations.
• Over-the-counter and prescription medicines, as long as they are shown on an itemised pharmacy receipt or an invoice.
• Blood tests, X-rays, CT scans, MRIs, ultrasounds and other diagnostic tests.
• Surgery, hospital stays and transplants.
• Dental treatment, dental and medical prostheses, prescription glasses and contact lenses.
• Physiotherapy, rehabilitation, nursing care and doctor-prescribed therapies.
• Thermal spa treatments, though travel and lodging are excluded.
• Buying or renting medical devices and healthcare equipment.

What does not count

You cannot claim travel and lodging connected to a treatment, even when the treatment is done abroad. Special medical foods also stay outside (no longer deductible since 2019), and so does any part someone else has already refunded: if your insurer gave you back 200 euros on a 600 euro invoice, only the share you actually paid goes into the deduction.

Receipts and invoices: what you need to keep

The deduction is built on documents. For medicines you need the itemised pharmacy receipt, that is, the receipt showing what the products are, their type and quantity, and your tax code: without those details the pharmacy receipt means nothing to the tax office. For visits, tests and treatments, the invoice or fiscal receipt with the tax code of whoever paid is enough.

• Itemised pharmacy receipts, with the tax code and the detail of the medicines.
• Invoices and fiscal receipts for visits, tests, procedures and therapies.
• Optician receipts for glasses and lenses, with the doctor's prescription.
• Paperwork for disability costs, with the certificates that are required.
• Proof of payment: since 2020 some expenses require a traceable payment (bank transfer, card or cheque), with exceptions for medicines, medical devices and services from public or accredited facilities.

Where most of it already is

Good news: on the pre-filled return many medical costs arrive already filled in, thanks to the data pharmacies and health facilities send through the health card. But «already filled in» does not mean «complete»: costs paid abroad are often missing, so are those of people who are exempt, and the deductions of anyone who paid for a relative. Our job is to compare the pre-filled return with your envelope of receipts and add what is missing.

Costs paid abroad

Treatment paid for outside Italy can still be deducted, but the documentation must be written in or translated into Italian. And the rule from before still stands: no refund for travel and lodging, only for the medical care itself.

Who can claim the medical expenses deduction

The basic rule is one only: the deduction belongs to whoever paid. If you paid for your mother's appointment, you find the deduction in your own 730. The costs of dependants — partner, children, parents — are added to yours, as long as they really are dependants for the income allowed by law. Watch one detail: the name on the invoice and the name of the payer must match, otherwise the expense needs to be documented carefully.

Illnesses exempt from the ticket

There is one case where the cost can be deducted even for a relative who is not a dependant: treatment connected to an illness exempt from contributing to public healthcare. In that case, the part of the cost that found no room in the sick person's income tax can be claimed by the family member who covered it, up to a maximum of 6,197.48 euros a year. You do need the right documents: the local health authority certificate, the medical certificate linking the cost to the illness, and the receipts showing who paid.

If the cost was refunded

Do you have private health insurance, or did the health service refund the cost? Then only the share that was not given back can be deducted. Claiming the full amount is one of the mistakes the tax agency spots most often in checks, and it means paying the benefit back with interest.

How to claim it on the 730 and when the money arrives

On the 730 form, ordinary medical costs go on lines E1 and E2 of box E, while costs for people with disabilities have a line of their own. If you file your 730 through us, we handle the filling in: you bring the documents, we check the result together and then we send it. If you use the online pre-filled return instead, remember to check the health expenses section before sending.

The saving does not arrive as a separate bank transfer. If you have a tax withholding agent — an employer or a pension fund — the deduction is spread across your payslips or pension payments in the months after filing. File early and the money starts coming back in summer: waiting until September also means waiting for the refund.

When spreading it out pays off

For anyone with very high health costs — we are talking over 15,493.71 euros in a single year — the law allows you to split the deduction into four equal parts, one per year. That can be useful when that year's income tax is not enough to use the whole benefit. But careful: the choice is made in the return for the year you paid, and it can no longer be changed afterwards. It is one of those cases where half an hour of advice before sending can be worth hundreds of euros.

Five mistakes that cost you the deduction

• Throwing away pharmacy receipts: without an itemised receipt, medicine costs cannot be declared.
• Leaving the tax code off invoices and receipts: the document belongs to nobody.
• Forgetting the costs of dependants: they are deductible even when the document is in their name.
• Deducting the share the insurer already refunded: you recover only what you paid yourself.
• Leaving foreign costs out of the return because «they are not Italian»: they are deducted with documents in Italian.

Sandra, the one with the envelope of receipts, got back more than 200 euros on a year of medicines and visits. It is not a dizzying figure, but it was money she had already spent and risked leaving there. If you too have a drawer full of receipts, do not wait for next June: bring it to the office and let's see together what it is worth.