See all health expenses that increase the IR refund

Medical and hospitalization expenses can enter the 2022 Income Tax return and guarantee a discount on the tax owed or increase the refund receivable. Unlike education spending, the category has no deduction limit.

According to the Federal Revenue, deductible expenses are limited to payments made by the declarant for his own treatment or that of dependents.

Expenses with health care for those receiving child support (those who receive alimony formalized in court or approved at a notary’s office) can also be deducted, provided that the payment of these expenses has been determined by Justice or approved by public deed.

The expenses to be deducted, in all cases, must be related to the treatment of illnesses or the recovery of the individual’s physical and mental health. As a rule, they must be included in the final bill charged by professionals or hospitals. Expenses at pharmacies, for example, do not generate a deduction.

“As there is no limit, the ideal is for the declarant to spend time on this part, because the more expenses he remembers to declare, the greater the deduction. But it is important that they are very well proven”, says Felipe Coelho, tax manager at EY consultancy .

See what are the expenses that can be deducted in the IR

• Health insurance
• Hospital admissions, consultations of any specialty and laboratory and radiological exams
• Covid-19 tests carried out in hospitals and laboratories
• Orthopedic devices and orthopedic prostheses (such as mechanical legs and wheelchairs, in addition to shoes and special insoles) or dental devices (such as dentures and crowns), provided that the doctor’s or dentist’s prescription indicating their use and the invoice, on behalf of of the beneficiary
• Placement and maintenance of orthodontic appliance; the expense with the purchase of the device is only deductible if included in the bill issued by the dentist
• Surgery for intraocular lens placement; the lens deduction follows the same rule as the device: it must be included in the payment to the professional or establishment
• Education of people with physical or intellectual disabilities, attested in a medical report and whose payment has been made to entities intended for this public
• Health plans or benefit providers that provide home health care or emergency pre-hospital care, such as mobile ICUs (Intensive Care Units)
• Hospitalization of the elderly in a geriatric establishment, such as nursing homes, provided that the place meets the standards of the Ministry of Health and has licenses approved by the competent authorities
• Plastic surgery, repairing or not, with the purpose of preventing, maintaining or recovering the patient’s physical or mental health. Expenses with silicone implants are not deductible, except when their value integrates the hospital bill
• Surgical instrumentator included in hospital bill
• Hospital admissions at home, as long as they include an invoice issued by the hospital
• Pacemaker included in hospital or professional bill
• Blood transfusion for which payment was made to specialized and qualified professionals and companies
• Payment to massage therapists, nurses and social workers, as long as they are included in the hospital bill
• Payment to hospitals and doctors for assisted reproduction services and examinations through in vitro fertilization; the expense must be deducted from the declaration of the woman, patient in treatment, unless she appears as a dependent of another declarant

spending abroad

Medical or hospitalization expenses incurred abroad can be deducted, but they also require supporting documentation.

Payments in any foreign currency must be converted into US Dollars, as quoted on the date of payment by the monetary authority of the country where the expense was made. Afterwards, the amount must be converted into reais using the quotation established by the Central Bank of Brazil for the last business day of the first fortnight of the month prior to payment.

But be careful: travel and accommodation expenses for medical treatment abroad cannot be deducted.

childbirth expenses

If the couple files the statements separately and neither is entered as dependents of the other, it is generally not possible for the husband to deduct his wife’s own expenses. The exception is the cost of giving birth to a common child, which can be deducted by either of the two, according to the IRS.

Health expenses that cannot be deducted

Expenses with:

• Amounts covered by insurance or reimbursed by them
• Covid-19 tests done in pharmacy or self-tests
• Glasses and contact lenses
• Companion expenses such as hospital accommodation
• DNA tests to prove paternity
• Umbilical cord stem cell collection, selection and storage services
• Medicines and vaccines, unless included in a bill issued by a hospital
• Assisted reproduction payments using “surrogacy”, even if paid to professionals or hospitals, as well as related exams
• Expenses with people who are not dependent or feeding
• Travel and accommodation expenses for medical treatment, in Brazil and abroad

How to prove

Expenses must be declared on the “Payments Made” form, with receipts that include the CPF (Individual Taxpayer Registry) or CNPJ (National Taxpayer Registry for Legal Entities) of the service provider, the identification of the payer and the beneficiary of the treatment or service and the date of issue. If the document included is not an invoice, it must contain the service provider’s signature.

In the absence of these documents, the expense can be proven by means of proof of payment, such as a cashier’s check.

If the receipt does not specify who was the beneficiary of the service (declarant, dependent or supporting), the Revenue will assume that it was the declarant. Therefore, in case of discrepancy with the tax information provided by the health institution to the tax authorities, the taxpayer may fall into the fine mesh.

To prevent this from happening, even if the information is not included on the invoice, it is possible to prove who was the beneficiary of the service with a statement from the professional or company that issued the receipt.

When declaring, it is also important to specify which amounts were reimbursed by health plan or insurance, Felipe Coelho recalls, and those disbursed by the taxpayer, in plans with co-payment, for example.