Medical Expense Deductions in Canada: What You Can and Can’t Claim (2024–2025 Guide)

Last updated: July 17, 2025. Figures current to the most recently published CRA guidance for the 2024 tax year; federal threshold amounts are indexed annually, so check for 2025 updates before you file. This article explains the Medical Expense Tax Credit (METC)—a powerful but often underused way to reduce your Canadian income tax—and clarifies the most commonly eligible and ineligible expenses. :contentReference[oaicite:0]{index=0}

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1. Why the Medical Expense Tax Credit (METC) Matters

The METC is a federal non‑refundable tax credit that reduces the amount of income tax you owe when you (or certain family members) incur qualifying out‑of‑pocket medical costs not otherwise reimbursed. Because Canada’s public health coverage doesn’t pay for everything—think dental work, many prescriptions, devices, travel, and more—tracking these expenses can produce meaningful tax savings, especially for households facing high health costs, chronic conditions, or specialized care needs. :contentReference[oaicite:1]{index=1}

2. Credit vs. Deduction vs. Refund: Know the Difference

The METC is not a deduction from income; instead, you calculate eligible expenses, reduce them by a threshold amount (see below), and then apply the federal credit rate (15% for recent years) to the remainder; a similar calculation applies at the provincial/territorial level. Because it’s non‑refundable, it can reduce tax owing to zero but won’t by itself generate a refund if you had no tax payable—although combining claims with other credits (and with-source deductions made through the year) can still increase your refund. Some taxpayers with low earned income may also qualify for the Refundable Medical Expense Supplement, which can provide an actual cash benefit. :contentReference[oaicite:2]{index=2}

3. Who You Can Claim (Line 33099 vs. Line 33199)

CRA splits claims between two main lines on your T1 return:

• Line 33099 – Total eligible medical expenses paid for yourself, your spouse or common‑law partner, and your (or your spouse’s) children under 18 at year‑end. :contentReference[oaicite:3]{index=3}
• Line 33199 – Allowable medical expenses for other dependants: adult children (18+), grandchildren, and a wide circle of close relatives (parents, grandparents, siblings, aunts/uncles, nieces/nephews) who were Canadian residents at any time during the year and depended on you for support. :contentReference[oaicite:4]{index=4}

You must calculate a separate threshold reduction for each dependant claimed on Line 33199. :contentReference[oaicite:5]{index=5}

4. Choosing Your 12‑Month Claim Period (and 24‑Month Death-Year Rule)

You are not locked to the calendar year. You may claim eligible medical expenses paid in any 12‑month period ending in the tax year you’re filing, provided those expenses were not claimed in the prior year. Strategic choice of this window lets you bunch large expenses (e.g., braces + surgery) into one claim year to clear the threshold more easily. :contentReference[oaicite:6]{index=6}

In the year of a taxpayer’s death, the rule expands: you can claim eligible medical expenses paid in any 24‑month period that includes the date of death, as long as the amounts were not claimed elsewhere. This applies both to expenses of the deceased and, in certain cases, to eligible dependants. :contentReference[oaicite:7]{index=7}

5. The Threshold: 3% of Net Income or Fixed Amount (& How Indexing Works)

For federal purposes in the 2024 tax year you subtract the lesser of (a) 3% of net income (line 23600) and (b) $2,759 from total eligible expenses for Line 33099 claims. The same fixed amount and 3% test apply when calculating the allowable amount for each dependant on Line 33199. The fixed dollar ceiling is indexed annually; expect a modest increase for 2025—confirm the updated figure on CRA’s indexation chart when you prepare that year’s return. :contentReference[oaicite:8]{index=8}

6. Strategic Tips to Maximize Your Claim

• Have the lower‑income spouse claim shared family expenses. Because the 3% floor is tied to the claimant’s net income, putting the claim on the lower‑income return often yields a larger credit. :contentReference[oaicite:9]{index=9}
• Bunch expenses into a high‑cost 12‑month period. Time elective procedures (when feasible) so that major costs fall within one claim window. :contentReference[oaicite:10]{index=10}
• Coordinate with reimbursements. Only the unreimbursed portion is claimable—track what your private plan or provincial plan paid. :contentReference[oaicite:11]{index=11}
• Capture employee‑paid insurance premiums (T4 Box 85 where reported). These can materially increase your claim base. :contentReference[oaicite:12]{index=12}
• Don’t forget travel & ancillary costs (parking, meals) when distance rules are met. These commonly missed items can push you over the threshold. :contentReference[oaicite:13]{index=13}

7. What You Can Claim: Detailed Eligibility Categories

The CRA publishes an extensive—but not exhaustive—list of allowable expenses. Below are the categories most frequently relevant to individual taxpayers. Always retain receipts and any required prescriptions or certifications. :contentReference[oaicite:14]{index=14}

7.1 Attendant Care & Care in a Facility

Amounts paid to attendants who perform personal tasks an individual cannot do for themselves—whether in the patient’s home, a retirement residence, group home, or nursing home—may qualify, subject to conditions. The attendant must be 18+ and not your spouse/partner. :contentReference[oaicite:15]{index=15}

Full‑time care (e.g., nursing home with 24‑hour nursing): Generally, the entire cost—including food, accommodation, nursing, administration, maintenance, and activity fees—is an eligible medical expense. :contentReference[oaicite:16]{index=16}

Partial/retirement home settings: You may claim the attendant care component (salaries and wages for care aides, nursing, housekeeping tied to personal care) but typically not basic rent, food, or general operating costs—unless included in eligible staff costs or special rules apply (and often linked to Disability Tax Credit eligibility). Obtain a detailed statement from the facility. :contentReference[oaicite:17]{index=17}

7.2 Care, Treatment & Training (Incl. Gender‑Affirming & Fertility‑Related Expenses)

Broad categories of medical care—surgeries, therapies (physio, speech, occupational), specialized training to care for a dependent with an impairment, and medically required procedures—are often eligible when prescribed and provided by an authorized medical practitioner under provincial/territorial law. :contentReference[oaicite:18]{index=18}

The federal government expanded METC eligibility for fertility‑related expenses, including certain surrogacy and donor costs, to reduce barriers to family building. Confirm that services are medically indicated and that receipts identify the authorized providers. :contentReference[oaicite:19]{index=19}

7.3 Construction & Renovation for Medical Need

Reasonable expenses to renovate a dwelling for medical accessibility or to accommodate a disability—such as installing ramps, widening doorways, modifying bathrooms, or specialized ventilation (e.g., sealed combustion furnace for severe respiratory illness)—may qualify when primarily for medical care and not expected to increase the property’s value (or only the medically required incremental cost counts). Certification is often required. :contentReference[oaicite:20]{index=20}

7.4 Devices, Durable Medical Equipment & Supplies

A long list of prescribed devices is eligible: wheelchairs, hearing aids (and batteries), artificial limbs/eyes, kidney machines (purchase + repairs), oxygen equipment, insulin delivery devices, and many more specified in CRA’s device lists and technical folio. Ensure you have a prescription or proof of medical necessity where required. :contentReference[oaicite:21]{index=21}

7.5 Prescription Drugs, Medications & Medical Cannabis

Prescription medications recorded by a pharmacist and prescribed by an authorized practitioner are generally eligible. Over‑the‑counter (OTC) drugs—even if recommended or “prescribed” informally—do not qualify. :contentReference[oaicite:22]{index=22}

Medical cannabis purchased in accordance with federal medical cannabis regulations (i.e., from a licensed medical seller and supported by proper medical authorization/registration) is an eligible medical expense; however, costs associated with growing your own cannabis are generally not eligible. :contentReference[oaicite:23]{index=23}

7.6 Service Animals & Related Costs

The cost of acquiring and caring for a specially trained service animal that assists with a person’s significant impairment (including certain mental impairments) may be claimed. Eligible ongoing costs can include food, veterinary care, and training, provided the animal is trained by a recognized organization and serves the individual’s diagnosed need. :contentReference[oaicite:24]{index=24}

7.7 Private Health Services Plan (PHSP) Premiums

Employee‑paid premiums to an eligible Private Health Services Plan (medical, dental, hospitalization) qualify as medical expenses and can be claimed by the employee (Box 85 on T4 when reported; Box 135 on T4A for former/retired employees). To be a PHSP, “all or substantially all” (generally ≥90%) of premiums must relate to expenses eligible for the METC. :contentReference[oaicite:25]{index=25}

7.8 Travel for Medical Services (40 km / 80 km Rules)

You may claim travel to obtain medical services not available closer to home if you took a reasonably direct route and travel was reasonable in the circumstances. When the one‑way distance exceeds 40 km, you can claim public transportation (bus, train, taxi). If public transit isn’t available, reasonable vehicle expenses may be allowed. When the one‑way distance exceeds 80 km, you can also claim vehicle costs, accommodation, meals, and parking, subject to recordkeeping and method rules (detailed vs. simplified km/meal rates). A companion’s travel costs may be claimed if medically required. :contentReference[oaicite:26]{index=26}

7.9 Out‑of‑Country Medical Expenses

Medical services received outside Canada can be eligible provided they are lawful services rendered by authorized practitioners or licensed hospitals in the jurisdiction of treatment, and the usual METC rules (unreimbursed, within claim period, medically required) are satisfied. Document why equivalent care was not available locally, especially if travel costs are included. :contentReference[oaicite:27]{index=27}

8. Special Situations & Interactions

8.1 Disability Tax Credit (DTC) & Attendant Care Interplay

Claiming full nursing home fees as a medical expense generally precludes also claiming the DTC for that individual; however, partial claims for attendant care wages may allow you to claim both in limited scenarios (follow CRA’s charted rules and required certifications). :contentReference[oaicite:28]{index=28}

8.2 Disability Supports Deduction vs. METC

Certain supports (e.g., sign‑language interpretation, note‑taking, etc.) can be claimed either as a Disability Supports Deduction (line 21500) or as medical expenses (line 33099/33199), or split between the two—but the total claimed across lines cannot exceed what you actually paid. Compare which yields the better overall tax result. :contentReference[oaicite:29]{index=29}

8.3 Employee Benefit Plans & Reimbursements

If a PHSP or employer benefit plan reimburses you, only the unreimbursed portion can be claimed as a medical expense; reimbursements included in taxable income may be treated as if you paid them yourself. Keep the year‑end PHSP summary and any T4 reporting for Box 85 to substantiate your out‑of‑pocket share. :contentReference[oaicite:30]{index=30}

8.4 Non‑Residents & Multi‑Jurisdiction Families

Certain relatives must be Canadian residents at some point in the year to be claimed under Line 33199; special rules apply for non‑residents and deemed residents, so consult the non‑resident guide if you have cross‑border family circumstances. :contentReference[oaicite:31]{index=31}

8.5 Death of a Taxpayer

Remember the expanded 24‑month window in the year of death; this can allow you (as a legal representative) to scoop up substantial unclaimed medical costs incurred before passing. Attach supporting receipts to the final return. :contentReference[oaicite:32]{index=32}

9. What You Cannot Claim (Common Pitfalls)

Some health‑related costs feel medical but don’t qualify under METC rules. Avoid these frequent errors:

• Over‑the‑counter medications, vitamins, supplements (even if “recommended”). :contentReference[oaicite:33]{index=33}
• Fitness club memberships / gym fees unless specifically prescribed equipment meeting device criteria (rare). :contentReference[oaicite:34]{index=34}
• Purely cosmetic surgery or procedures undertaken solely for aesthetic purposes (medically required reconstructive procedures remain eligible). :contentReference[oaicite:35]{index=35}
• Diaper services (note: incontinence supplies purchased may qualify separately—check receipts). :contentReference[oaicite:36]{index=36}
• Personal emergency response systems (unless qualifying as a prescribed medical device under specific criteria). :contentReference[oaicite:37]{index=37}

10. Documentation & Audit Readiness Checklist

CRA does not require you to submit receipts with an e‑filed return, but you must keep them (paper or digital) in case requested. Good documentation increases audit survivability and speeds processing if reviewed. Use this checklist:

• Detailed receipts showing provider name, date paid, amount, and service description; for drugs, retain pharmacy printouts. :contentReference[oaicite:38]{index=38}
• Prescriptions / medical practitioner certifications where required by CRA’s eligible expense list (check authorized practitioner by province). :contentReference[oaicite:39]{index=39}
• PHSP / insurance statements separating what was reimbursed vs. what you paid. :contentReference[oaicite:40]{index=40}
• Travel logs (dates, destinations, km, purpose) and accommodation / meal receipts for eligible medical trips. :contentReference[oaicite:41]{index=41}
• Facility breakdowns for retirement or nursing homes clearly separating care wages from non‑eligible rent/food components. :contentReference[oaicite:42]{index=42}

11. Step‑by‑Step Calculation Example

Let’s walk through a simplified illustration inspired by CRA’s example to show the mechanics and planning opportunities.

12. Quick FAQ

Do I have to use January–December receipts?

No. Pick any 12‑month period ending in the tax year (e.g., Nov 1–Oct 31) to bunch expenses. :contentReference[oaicite:47]{index=47}

Can I carry forward unclaimed medical expenses?

You can’t simply “carry forward” indefinitely, but because you can choose the 12‑month window, you can include late‑year expenses in the next year if you haven’t already claimed them. :contentReference[oaicite:48]{index=48}

My employer paid part of my dental plan; can I claim the rest?

Yes—your out‑of‑pocket PHSP premiums and unreimbursed expenses are claimable; don’t double‑count amounts reimbursed. Check T4 Box 85 and plan statements. :contentReference[oaicite:49]{index=49}

Are gluten‑free foods eligible?

For those with certified celiac disease, you can claim the incremental cost of gluten‑free products over regular equivalents when properly documented. :contentReference[oaicite:50]{index=50}

Can I claim travel to a specialist in another city?

Yes if comparable services aren’t available within 40 km; beyond 40 km you can claim public transit (or reasonable vehicle costs if none available); beyond 80 km add meals, lodging, and parking. Keep logs! :contentReference[oaicite:51]{index=51}

What if the patient died?

You may claim eligible expenses paid in any 24‑month period that includes the date of death (subject to the usual unreimbursed rule). :contentReference[oaicite:52]{index=52}

13. Wrap‑Up & Next Steps

The Medical Expense Tax Credit rewards diligent recordkeeping. Between allowable care costs, specialized devices, PHSP premiums, and overlooked travel expenses, many families leave money on the table each year. Start a digital “medical tax” folder today; ask providers for annual statements; capture mileage as you go; and before filing, test who in the household should claim and which 12‑month window yields the best result. If your situation involves disability, long‑term care, surrogacy/fertility, or complex family support, consider professional advice to coordinate METC with other credits like the Disability Tax Credit and the Refundable Medical Expense Supplement. :contentReference[oaicite:53]{index=53}

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This article provides general information only and is not a substitute for personalized tax advice. Tax rules change; always confirm current CRA guidance before filing. :contentReference[oaicite:54]{index=54}

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