The Complete Guide to Canada’s Medical Expense Tax Credit (METC) for Private Surgeries in 2025

Quick Hits

• The METC is a non-refundable credit that reduces your taxes when you pay out-of-pocket for eligible medical expenses, including medically necessary private surgeries performed by authorized practitioners.
• You can claim for any 12-month period ending in your tax year. Many people “bunch” expenses to maximize the claim (more on bunching below).
• You only get a credit for the portion above the lesser of 3% of your net income or the fixed federal amount (we'll break this down below in easy to understand terms).
• Travel can be eligible if you must go ≥40 km (transportation) or ≥80 km (transportation plus reasonable meals and lodging) to access needed medical services not available closer.
• Keep thorough documentation: invoices, proof of payment, practitioner/facility details, insurance statements, and travel logs.

Who This Guide Is For

Anyone who has had or is considering private surgery (e.g., hip or knee replacement, gallbladder removal, cataract) and wants to understand how the METC can be applied to surgical expenses.

What Is the METC?

The Medical Expense Tax Credit (METC) reduces your taxes based on eligible medical expenses you pay yourself. It’s non-refundable, so it can bring your tax to zero but not create a refund on its own.

Are Private Surgeries Eligible?

If the surgery is:

• medically necessary (i.e. not purely cosmetic);
• performed by an authorized medical practitioner; and
• the costs are not reimbursed by provincial plans or private insurance

then the out-of-pocket portion is generally eligible for the METC.

Examples include orthopedic procedures (hip/knee), gallbladder removal, hernia repair, and cataract surgery.

Cosmetic-only procedures are excluded; but reconstructive or medically necessary exceptions may qualify. For example, breast reconstruction after a a mastectomy, surgery to correct birth defects,

Quick Eligibility Checklist

• Medically necessary (not purely cosmetic).
• Performed by an authorized medical practitioner (per provincial/territorial law).
• In a licensed facility when required (hospital or licensed private hospital).
• You paid out-of-pocket (non-reimbursed portion only).
• Paid within any 12-month period ending in your tax year.

What You Can Claim (Common Categories for Private Surgery)

Direct Medical Costs

• Professional fees (surgeon, anesthesiologist, assisting physicians).
• Facility fees and hospital charges.
• Diagnostic imaging and lab tests related to the procedure.
• Prescribed medications and medical devices associated with the surgery.
• Post-operative nursing, prescribed rehab/physiotherapy where eligible.

For a complete list, see Lines 33099 and 33199 - Eligible medical expenses you can claim on your tax return.

Travel for Medical Care

• ≥40 km (one way): transportation (public transit, or vehicle using simplified per‑km or detailed method).
• ≥80 km (one way): add reasonable meals and lodging to transportation.
• You must show that substantially equivalent services weren’t available closer to home and that your route was reasonable and direct.
• If a patient needs an attendant for medical reasons, that person’s reasonable travel costs may also be eligible. Keep medical documentation supporting the need.

In order to claim transportation and travel expenses, you must demonstrate all of the following:

• "Substantially equivalent medical services were not available near your home.
• You took a reasonably direct travelling route.
• It is reasonable, under the circumstances, for you to have travelled to that place for those medical services."

What You Cannot Claim

• Amounts reimbursed by a provincial plan or insurance.
• Purely cosmetic procedures and associated costs.
• Non-prescription medications and general wellness items.

How Much Can You Claim? (2025)

• Threshold: You can claim the amount above the lesser of 3% of your net income or the federal fixed-dollar amount.
• 2025 federal fixed-dollar amount: $2,759 (current as of 2025).
• Strategy: It can make sense for the lower‑income spouse to claim the family’s medical expenses to reduce the 3% floor.

Timing Advantage: The 12-Month Claim Window

You can choose any 12‑month period ending in your tax year. Many families group (“bunch”) large expenses—like a private surgery, related diagnostics, and travel—within one 12‑month period to maximize the claim in one year.

• Example A (single): If your net income is $55,000, 3% is $1,650. If your eligible expenses are $7,000, your claimable amount is $7,000 – $1,650 = $5,350 (before credit rates).
• Example B (family): If the lower-income spouse has net income of $40,000, 3% is $1,200. If joint eligible expenses are $12,000 (hip replacement + travel), claimable amount is $12,000 – $1,200 = $10,800 (before credit rates).

Documentation: Make Your Claim Audit-Ready

• Invoices and receipts: show provider names, dates, services, amounts.
• Proof of payment: card/bank statements.
• Practitioner authorization and facility licensing (where relevant).
• Prescriptions/referrals for services that require them.
• Insurance statements (EOBs) showing what was reimbursed and what wasn’t.
• Travel: logs (dates, origin/destination, distance, purpose), tickets/boarding passes, hotel invoices, parking, meal receipts, or simplified allowances where allowed.

You need to keep this documentation available at all times in case the CRA asks to see it later.

Special Situations

• Out-of-province or out-of-country: costs may be eligible if performed by licensed practitioners/facilities; travel rules still apply. Keep extra documentation.
• Wait-time driven private care: still potentially eligible if it meets the general criteria (medically necessary, authorized practitioner, non-reimbursed).
• Private Health Services Plans (PHSP/HSA): Incorporated business owners may use PHSPs to reimburse medical costs pre‑tax, which can be more efficient than the personal METC in some scenarios. Must meet CRA rules (bona fide employment relationship, reasonable limits, non-discriminatory classes, third-party administration).

Step-by-Step Filing Walkthrough

• Choose your 12‑month period ending in the tax year to capture the most expenses.
• Enter medical expenses on the appropriate lines:
  • Yourself/spouse or common‑law partner/children under 18: federal line 33099.
  • Other eligible dependants: federal line 33199 (additional rules apply).
• Subtract the lesser of 3% of your net income or the federal fixed amount ($2,759 for 2025).
• Apply the federal and your provincial/territorial medical credits.
• Quebec-only notes: see the Quebec section below for non-refundable and refundable credit details.

Provincial/Territorial Details, Travel Examples, PHSPs, and FAQs

How Federal and Provincial/Territorial Credits Stack

You’ll claim the federal METC and a provincial/territorial medical expense credit. Provincial rules and rates vary and are updated regularly. Confirm current-year provincial amounts when you file.

British Columbia

• Stacking: Federal METC plus BC medical expense credit.
• Practical tip: For travel claims, keep a clear mileage log or use the CRA simplified per‑km method plus receipts for parking/meals where allowed. Maintain proof that substantially equivalent services were not available closer to home.

Alberta

• Stacking: Federal METC plus Alberta medical expense credit.
• Practical tip: Large provinces often involve long drives; detailed travel records reduce review risk. Private orthopedic/general surgery costs are commonly claimed when medically necessary and non‑reimbursed.

Saskatchewan

• Stacking: Federal METC plus Saskatchewan medical expense credit.
• Practical tip: Ensure invoices show practitioner credentials and facility details. Only the non‑reimbursed portion is eligible.

Manitoba

• Stacking: Federal METC plus Manitoba medical expense credit.
• Practical tip: Manitoba also has a separate refundable Fertility Treatment Tax Credit (not surgery-specific). For private surgeries, keep full documentation and EOBs to show what wasn’t reimbursed.

Ontario

• Stacking: Federal METC plus Ontario medical expense credit.
• Practical tip: “Authorized medical practitioner” status is defined by provincial law. Keep evidence of practitioner type and licensing where relevant. Non‑reimbursed private surgery costs (hip/knee, hernia, cataract) are typically eligible.

Quebec

• Stacking: Federal METC plus Quebec’s non-refundable medical expense credit on expenses exceeding 3% of family net income.
• Quebec also offers a refundable medical expense credit (Line 462) based on work and family income thresholds. It may benefit lower-income households.
• Practical tip: Quebec paperwork can differ. Keep all documentation and note any RAMQ premiums or plan interactions per Quebec guidance.

New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador

• Stacking: Federal METC plus each province’s medical expense credit.
• Practical tip: Many patients travel to regional hubs; keep ferry/air travel records, hotel invoices, and meal receipts (or use simplified allowances if permitted). Show why services weren’t available closer to home.

Yukon, Northwest Territories, Nunavut

• Stacking: Federal METC plus territorial medical credits.
• Practical tip: Long-distance travel is common. The ≥40 km and ≥80 km thresholds matter. Keep robust logs, tickets, and a clear note on local availability.

Travel: What Counts and How to Record It

Key Rules (Canada-Wide)

• ≥40 km (one way): claim transportation (public transit, or vehicle).
• ≥80 km (one way): claim transportation plus reasonable meals and lodging.
• Your route should be reasonable and direct. Services should not be available closer to home.

Example 1 — 60 km for a private hernia consult

• Eligible: transportation costs.
• Records: transit tickets or vehicle km log (simplified rate or detailed receipts), parking.

Example 2 — 120 km for a private knee replacement

• Eligible: transportation plus reasonable meals and lodging.
• Records: hotel invoice, meal receipts or simplified meal allowance (where applicable), mileage log, parking.

Example 3 — Out-of-province cataract surgery

• Eligible: same rules; if ≥80 km, include meals/lodging.
• Records: boarding passes, hotel receipts, meal documentation, practitioner/facility details, and a note explaining why services weren’t reasonably available closer.

Private Health Services Plans (PHSP/HSA) for Business Owners

• What it is: A CRA-accepted arrangement allowing incorporated businesses to reimburse medical expenses pre‑tax, often more efficient than claiming the METC personally.
• When it may outperform the METC: large out-of-pocket costs (e.g., private joint replacement) and your corporate/personal tax mix favours pre‑tax reimbursement.
• Compliance essentials: bona fide employment relationship, reasonable limits, non‑discriminatory plan classes, third‑party administration, proper receipts and plan documentation.

FAQs

Are private surgeries eligible for the METC?

Generally yes, if medically necessary, performed by authorized practitioners, and not reimbursed by public plans or insurance. Purely cosmetic procedures are excluded; reconstructive or medically necessary exceptions may qualify.

What is the 2025 federal fixed-dollar threshold?

For 2025, the federal fixed-dollar amount is $2,759. You claim the portion above the lesser of 3% of your net income or $2,759.

Can I split medical expenses between spouses?

No. You choose one spouse/partner to claim the combined family expenses. It often helps to choose the lower‑income spouse to reduce the 3% floor.

Can I claim travel if the surgery is available closer but the wait is longer?

CRA expects that substantially equivalent services aren’t available closer to home. A longer wait time nearby does not automatically justify farther travel for claim purposes. Keep documentation and seek professional advice for edge cases.

Are out-of-country procedures eligible?

Some are, if performed by licensed medical practitioners and the expenses are otherwise eligible. Travel rules still apply. Documentation is critical.

How Much Can You Expect From the METC?

What follows are purely hypothetical examples for educational purposes only. Your tax situation is likely unique, so please consult a tax professional for guidance.

Example 1: Private knee replacement in Ontario

• Profile: Single claimant, net income $55,000
• Eligible expenses:
  • Surgeon/facility/anesthesia: $18,000
  • Diagnostics and post-op physio (prescribed): $1,200
  • Travel (120 km one way, meals/lodging 2 nights): $450
  • Total eligible expenses: $19,650
• Threshold: Lesser of 3% of $55,000 = $1,650 or $2,759 → use $1,650
• Claimable expenses: $19,650 − $1,650 = $18,000

Estimated credits

• Federal METC: $18,000 × 15% = $2,700
• Ontario medical expense credit (illustrative at roughly 5.05% on the same base): $18,000 × 5.05% ≈ $909
• Estimated total tax reduction: ≈ $3,609

What this means

• If your tax payable is at least $3,609, your combined federal+Ontario credits could reduce it by about $3,609.

Example 2: Private hip replacement in British Columbia (lower-income spouse claims)

• Profile: Couple chooses lower‑income spouse with net income $40,000 to claim
• Eligible expenses:
  • Surgeon/facility/anesthesia: $22,000
  • Prescribed meds/devices: $600
  • Travel (200 km one way, meals/lodging 3 nights): $750
  • Total eligible expenses: $23,350
• Threshold: Lesser of 3% of $40,000 = $1,200 or $2,759 → use $1,200
• Claimable expenses: $23,350 − $1,200 = $22,150

Estimated credits

• Federal METC: $22,150 × 15% ≈ $3,323
• BC medical expense credit (illustrative at roughly 5.06%): $22,150 × 5.06% ≈ $1,120
• Estimated total tax reduction: ≈ $4,443

What this means

• If the lower‑income spouse has at least $4,443 of tax payable, the credits could reduce their tax by about $4,443. Choosing the lower‑income spouse helped clear a smaller 3% floor.

Example 3: Private gallbladder removal (cholecystectomy) in Alberta with longer travel

• Profile: Single claimant, net income $70,000; must travel 350 km one way
• Eligible expenses:
  • Surgeon/facility/anesthesia: $9,500
  • Diagnostics/post‑op follow‑up: $500
  • Travel (≥80 km: meals + lodging eligible; 2 nights): $650
  • Total eligible expenses: $10,650
• Threshold: Lesser of 3% of $70,000 = $2,100 or $2,759 → use $2,100
• Claimable expenses: $10,650 − $2,100 = $8,550

Estimated credits

• Federal METC: $8,550 × 15% ≈ $1,283
• Alberta medical expense credit (illustrative at roughly 10% on the same base for demonstration; actual AB medical credit calculation may vary with base amounts/surtaxes):
  $8,550 × 10% ≈ $855
• Estimated total tax reduction: ≈ $2,138

What this means

• If your tax payable is at least $2,138, your credits could cut it by about $2,138. In this case, travel pushed more costs into the claimable bucket because the threshold was $2,100.

Glossary

• METC: Non-refundable federal credit for eligible medical expenses you pay.
• Non-refundable credit: Can bring your tax to zero but doesn’t create a refund by itself.
• Authorized medical practitioner: Recognized under provincial/territorial law for METC purposes.
• Licensed facility: A hospital/private hospital licensed under provincial/territorial law where required.
• 12-month claim period: Any 12-month window ending in your tax year that you choose.
• PHSP/HSA: An employer plan that reimburses medical expenses under CRA rules, often used by incorporated business owners.

Final Reminders for 2025

• Federal fixed-dollar threshold (2025): $2,759.
• Choose your 12-month period wisely to “bunch” expenses.
• Keep receipts, proof of payment, EOBs, practitioner/facility details, and travel logs.
• Provincial/territorial rates and rules update regularly. Confirm current-year details at filing.