List of tax deductions
All the other items that reduce your tax.
OpenCAF services · Deductions
Medical expenses tax deduction
It is the most widely used deduction and the one with the most exceptions: the threshold, traceable payment, over-the-counter medicines, expenses paid for your children. Knowing them keeps eligible expenses from being left out of your return.
01 · What is included
Which medical expenses are deductible
The deduction applies to medical expenses paid during the year, for yourself and for family members who are your tax dependants. What counts is the healthcare service, not who provides it: both public and private providers qualify.
- Specialist and GP visits, including ticket charges (the patient contribution in the public health service).
- Medicines, both prescription and over-the-counter, provided the receipt is itemised and shows the code, type and quantity.
- Tests, diagnostic examinations, X-rays, MRI scans.
- Surgery and hospital stays, including care home fees for the healthcare portion.
- Dental treatment, with no limit on the amount.
- Prescription glasses, contact lenses and lens solutions, with a prescription or a self-certification.
- Medical devices with CE marking: hearing aids, orthopaedic mattresses, blood pressure monitors.
- Physiotherapy, speech therapy, psychotherapy and other services provided by qualified healthcare professionals.
Not included: cosmetic treatments with no therapeutic purpose, supplements and food products even if sold in a pharmacy, general parapharmacy products, and services provided by anyone not registered with a healthcare professional body. The word "health" on the receipt is not enough.
02 · The calculation
How the deduction is calculated
The deduction equals a percentage of the expense, calculated on the part that exceeds a fixed annual threshold. The threshold is applied only once, to the overall total, not to each individual expense.
- The threshold applies to the total medical expenses for the year, adding together your own and those of your dependent family members.
- If total spending exceeds a high threshold, you can spread the deduction over several equal annual instalments.
- The deduction is less tax to pay, not a refund: if your gross tax is zero, you recover nothing.
- Expenses reimbursed by insurance or a health fund are not deductible, except for the part you paid yourself.
- Premiums paid to supplementary health funds have their own treatment, separate from the expenses.
| Item | Treatment |
|---|---|
| General medical expenses | Deduction on the part above the threshold |
| Expenses for people with disabilities | Some items are deductible from income, with no threshold |
| Expenses for mobility aids and technical aids | Specific favourable treatment |
| Veterinary expenses | Deduction with its own threshold and a maximum cap |
| Care expenses for people who are not self-sufficient | A separate deduction with an amount limit and an income limit |
If you have health insurance through your employer, be careful: if the premium was excluded from your taxable income, expenses later reimbursed by the fund give no right to any deduction. Deducting them anyway is one of the most frequent findings in formal checks.
03 · Traceability
The traceable payment requirement
This is the rule that loses the most deductions, and it applies from the moment of payment: if you paid in cash where it was not allowed, there is no way to fix it afterwards.
The general rule
Medical expenses must be paid by traceable means (debit card, credit card, bank transfer, cheque) to be deductible.
The exceptions
Medicines, medical devices and services provided by public facilities or private facilities accredited with the Servizio sanitario nazionale (SSN, the Italian national health service) remain deductible even if paid in cash.
What accredited means
Being a healthcare facility is not enough: it must be accredited with the SSN. A purely private clinic falls under the general rule.
The proof
The electronic payment receipt, the bank statement or the invoice showing the payment method.
The classic case
How you lose the deduction without noticing.
- A visit to a private specialist, paid in cash
- A proper invoice, revenue stamp and all
- The expense does not appear in the pre-filled return
- Even if you enter it by hand, it is disallowed if checked
04 · Who can claim them
Expenses paid for family members
You can deduct expenses paid for family members who are your tax dependants, and the rule is clear: what counts is who paid the expense, not who received the treatment.
- Expenses for a dependent child are deducted in full by whoever paid them, or split between the parents according to their dependant percentage.
- The invoice should ideally show the codice fiscale (Italian tax code) of the person paying, or at least a note of who paid.
- The same rule applies to a dependent spouse.
- Expenses for family members who are not dependants are not deductible, with one important exception: medical expenses for people with disabilities, which are deductible even if the family member is not a dependant.
- Expenses for adult children remain deductible by the parent as long as the child is a tax dependant.
When two separated parents pay expenses for the same child, each deducts the part they actually paid. Putting everything on one parent's return because "it is easier" produces a deduction that is not due for the part that parent did not pay.
05 · What to keep
What you need and for how long
The pre-filled return already contains the expenses sent through the Sistema Tessera Sanitaria, but not all of them, and you must keep the documents anyway.
- Invoices and tax receipts with the codice fiscale of the person named on them.
- Itemised receipts for medicines, with the AIC code (the medicine's authorisation code), type and quantity.
- A medical prescription where required, or a self-certification for glasses and devices.
- Proof of traceable payment for every item that requires it.
- Documentation of the insurance reimbursement, to justify the part you paid yourself.
- Everything must be kept until the time limits for tax assessments expire, typically a few years after the return.
If you object to your data being sent to the Sistema Tessera Sanitaria (which you are allowed to do), you will find nothing in the pre-filled return and must bring all the documents. It is a legitimate choice, but you need to remember it when filing.
06 · The special regime
Medical expenses for people with disabilities
They have separate and more favourable treatment, which is often not used in full.
- General medical expenses and specific care expenses are deductible from total income rather than giving a tax credit, and with no threshold.
- They are deductible even if the family member is not a tax dependant.
- Mobility aids (wheelchairs, hoists, IT aids) benefit from a reduced VAT rate and a deduction with no threshold.
- Buying a vehicle has its own rules, with a deduction up to a spending cap and a multi-year frequency.
- Removing architectural barriers falls under the building bonuses, with a dedicated rate.
- The condition must be officially recognised: an invalidity report or certification under Law 104.
Frequently asked
The questions that keep coming up
I paid the dentist in cash. Can I deduct it?
Only if the dental practice is accredited with the Servizio sanitario nazionale, which is rare for private practices. In most cases paying in cash means losing the deduction.
It is not a question of proof: the expense is documented by the invoice, but the law requires traceable payment as a separate condition. For dental treatment, which often involves large amounts, it is worth remembering before you pay.
Are supplements deductible?
No. Food supplements are not considered medicines, even when recommended by a doctor and sold in a pharmacy.
The exception is where the product is classified as a medical device with CE marking: in that case it counts as a device, not a medicine, and the deduction applies.
The expenses are already in the pre-filled return. Do I need to bring the receipts?
Yes, for two reasons. The first is that the documents must be kept and produced if you are checked, even for pre-filled expenses you accept without changes.
The second is that the pre-filled return does not contain everything: often missing are expenses from providers outside the Sistema Tessera Sanitaria, those paid for family members, and those from healthcare professionals who do not send data.
I spent a lot on an operation. Can I spread the deduction?
Yes. When medical expenses for the year exceed a high threshold, you can choose to spread the deduction over several equal annual instalments.
It makes sense when your gross tax for the year is not enough to absorb it: by spreading it, you also recover the part that would otherwise be lost.
Let's talk
The pre-filled return finds many of them, but not all
What is missing is almost always expenses paid in cash where this is still allowed, those for dependent family members, and those from private providers outside the Tessera Sanitaria (national health card) system.