Quick answer: The Medical Expense Tax Credit (METC) is a federal non-refundable credit on eligible medical expenses above a threshold. For 2026, the threshold is the lesser of 3% of net income or $2,890. The federal credit rate is 14% on excess expenses (down from 15% under Bill C-4, effective July 1, 2025). Provincial METCs run at separate rates and lower thresholds, typically adding another 5-11%. Eligible expenses are summed for any 12-month period ending in the tax year — not just the calendar year.
What this means: Combining a family’s expenses on the lower-income spouse’s return usually produces the larger credit (smaller 3% threshold). A separate Refundable Medical Expense Supplement (max $1,534 for 2026) is available for working low-income claimants with earned income of at least $4,478 and family net income up to $33,960 (phase-out starts there).
What to do next: Estimate your 2026 METC and refundable supplement. Medical expense calculator →
How the METC works in 2026
Step-by-step:
- Sum eligible medical expenses paid in any 12-month period ending in the 2026 tax year (does not have to be the calendar year).
- Subtract the threshold: lesser of $2,890 or 3% of the claimant’s net income.
- Multiply the excess by 14% (the 2026 federal lowest-bracket rate). This is the federal non-refundable METC.
- Add the provincial METC — each province uses its own threshold and rate (typically 5%-11% of the excess). Provinces use the same eligible-expense list as the federal credit.
2026 federal METC figures
| 2026 METC figure | Amount |
|---|---|
| Federal threshold (3% of net income ceiling) | $2,890 |
| Federal lowest-bracket rate (METC rate) | 14% |
| Refundable medical expense supplement — maximum | $1,534 |
| Refundable supplement — minimum earnings to qualify | $4,478 |
| Refundable supplement — family net income phase-out starts at | $33,960 |
The 14% rate reflects Bill C-4 (Royal Assent March 2026, effective July 1, 2025), which reduced the federal lowest personal tax rate from 15% to 14%. All non-refundable credits computed at the lowest rate — including the METC — now apply at 14%.
The 12-month rule
Eligible expenses can be claimed from any 12-month period ending in the tax year — not just the calendar year. This flexibility lets you shift a large medical bill (orthodontics, fertility treatment, hearing aids, dental implants) into a single 12-month window for maximum credit.
Example. A family has $3,000 of expenses in March 2025 and $2,000 in November 2026. By choosing the 12-month period December 2025 to November 2026, they can claim both clusters on their 2026 return: $5,000 of total eligible expenses. The November 2026 expenses and the March 2025 expenses (since the period spans both) are all eligible.
Which spouse should claim?
The lower-income spouse usually produces a larger METC because the 3% threshold is smaller. Worked example with $5,000 of family medical expenses:
| Claimant | Net income | 3% of net income | Threshold applied (lesser) | Excess above threshold | Federal METC (14%) |
|---|---|---|---|---|---|
| Higher-earning spouse | $100,000 | $3,000 | $2,890 (cap wins) | $5,000 − $2,890 = $2,110 | 14% × $2,110 = $295.40 |
| Lower-earning spouse | $40,000 | $1,200 | $1,200 (3% wins) | $5,000 − $1,200 = $3,800 | 14% × $3,800 = $532 |
The lower-earning spouse generates a $236.60 larger federal credit on the same family expenses. Provincial METC stacks similarly. Always run the math for both spouses before deciding who claims.
Eligible medical expenses
Common eligible expenses (full CRA list at “Lines 33099 and 33199 – Eligible medical expenses”):
- Prescription medications (filled by a licensed pharmacist)
- Dental services and orthodontics
- Eye exams, prescription glasses and contact lenses, laser eye surgery
- Hearing aids, batteries, and repairs
- Medical practitioners (doctors, dentists, optometrists, physiotherapists, chiropractors, psychologists, etc.)
- Hospital and clinic services, including private room costs
- Insulin, syringes, glucose monitors, and other diabetic supplies
- Travel for medical care more than 40 km from home (vehicle, public transit; accommodation for trips over 80 km)
- Premiums paid to a private health insurance plan (the portion covering medical/dental, not the wage-loss portion)
- Premiums paid to provincial medical insurance plans (in some provinces)
- Care for a person with Disability Tax Credit approval (attendant care, group home, certain therapies)
- Fertility treatments (in-vitro, intra-uterine, certain medications, surrogacy-related medical expenses)
- Prescription contraceptives
- Wheelchairs, walkers, hospital beds, ramps, lifts, and other assistive devices
- Service animals (guide dogs, hearing-aid dogs, certain mobility-assistance dogs)
- Renovations to make a home accessible for a person with a severe disability
Common ineligible expenses
- Cosmetic procedures not medically required (the medical-necessity test is strict; reconstructive surgery after disease/accident is eligible).
- Over-the-counter medications without prescription (vitamins, supplements, common pain relievers).
- Health club memberships, weight-loss programs (with narrow exceptions for medically-prescribed programs).
- Expenses reimbursed by insurance — only the out-of-pocket portion is eligible.
- Funeral costs — not medical, even if death followed a medical event.
Travel expenses
Medical travel is eligible when the patient must travel at least 40 km one-way to access medical services not available locally. Eligible costs:
- Public transit, taxi, train, or bus fares.
- Vehicle expenses (simplified per-km rate published yearly by CRA, or actual expenses with receipts).
- Accommodation if the round trip exceeds 80 km.
- Meals (simplified rate or actual receipts).
- Costs for one accompanying person if the patient cannot travel alone.
Keep travel logs (date, distance, purpose, receipts). CRA may request documentation on audit.
METC for dependants
Medical expenses for a dependant relative (child age 18+, grandchild, parent, grandparent, brother, sister, uncle, aunt, niece, nephew) can be claimed by the supporting taxpayer on line 33199.
- The dependant must be a Canadian resident at any time in the year.
- The dependant must have been dependent on the taxpayer for support.
- For dependants other than minor children, the eligible amount is reduced by the dependant’s net income above a threshold.
Medical expenses for the taxpayer’s own minor children (under 18) are claimed on line 33099 alongside the taxpayer’s and spouse’s expenses (no income test).
METC interaction with the Disability Tax Credit
Approval for the Disability Tax Credit (DTC) unlocks additional eligible expenses, including:
- Attendant care up to specific limits (full-time attendant care, group home care).
- Certain therapies for a person with severe disability.
- Reasonable adjustments to the home or vehicle.
METC and DTC are separate credits but complementary. See Disability Tax Credit eligibility and DTC eligibility (Canada).
Refundable Medical Expense Supplement
The Refundable Medical Expense Supplement is a separate credit for working low-income Canadians with significant medical expenses. For 2026:
| 2026 supplement figure | Amount |
|---|---|
| Maximum supplement | $1,534 |
| Minimum earnings (work income) to qualify | $4,478 |
| Family net income phase-out start | $33,960 |
| Phase-out rate | 5% of family net income above $33,960 |
The supplement is the lesser of: (a) $1,534, (b) 25% of total eligible medical expenses above the regular METC threshold, or (c) 25% of disability supports deduction claimed. Reduced by 5% of family net income above $33,960. Phases out completely around $64,640 family net income.
Unlike the non-refundable METC, the supplement is refundable: you can receive it as a refund even if you have no tax owing.
Worked examples
Example 1: single filer with $40,000 net income, $4,500 expenses
- Threshold: lesser of $2,890 or 3% of $40,000 = $1,200. Threshold is $1,200.
- Eligible above threshold: $4,500 − $1,200 = $3,300.
- Federal METC: 14% × $3,300 = $462.
- Provincial METC (Ontario as example, lowest rate ~5.05%): ~$152 (using the same excess).
- Combined federal + Ontario: ~$614.
Example 2: couple, lower-earning spouse claims $7,000 expenses
Lower-earning spouse net income: $35,000. Higher-earning spouse net income: $95,000.
- Lower spouse threshold: lesser of $2,890 or 3% of $35,000 = $1,050. Threshold is $1,050.
- Eligible above threshold: $7,000 − $1,050 = $5,950.
- Federal METC: 14% × $5,950 = $833.
- Higher spouse alternative (if claimed instead): threshold = $2,890 (cap); excess = $4,110; federal METC = $575.40.
- Difference: $257.60 larger credit by using the lower-earning spouse.
Example 3: refundable supplement (low-income family)
Combined family net income: $28,000. Taxpayer’s earned income (employment): $18,000. Eligible medical expenses: $4,000.
- Earned income meets the $4,478 minimum.
- Family net income $28,000 is below the $33,960 phase-out start — no reduction.
- Excess medical expenses above the METC threshold: $4,000 − $840 (3% of $28,000) = $3,160.
- 25% of $3,160 = $790. Less than the $1,534 maximum.
- Refundable supplement: $790. Paid as a refund regardless of tax owing.
- Plus the non-refundable METC at 14% × $3,160 = $442.40 (offsets federal tax).
Common mistakes
- Defaulting to the higher-earning spouse. Run the math: the lower 3% threshold usually wins on the lower-income claimant.
- Using calendar year instead of any 12-month window. Re-pick your window to bundle large expenses.
- Forgetting the insurance reimbursement reduction. Only out-of-pocket expenses count.
- Claiming OTC products and supplements. Without a prescription, these are not eligible.
- Missing the refundable supplement. Low-income working claimants with medical expenses can receive up to $1,534 even with no tax owing.
- Forgetting to keep receipts. CRA can request documentation up to 6 years after filing.
Frequently asked questions
What is the 2026 federal METC threshold?
The lesser of $2,890 or 3% of the claimant’s net income. The lower of the two applies.
What is the 2026 federal METC rate?
14%. The lowest federal personal tax rate was reduced from 15% to 14% effective July 1, 2025 under Bill C-4. All non-refundable credits at the lowest rate — including the METC — are now 14% federally.
Can I claim a 12-month period that crosses calendar years?
Yes — that’s the point of the rule. The 12-month period must end in the tax year you’re filing. Choose the window that maximizes your eligible expenses above the threshold.
Are private health insurance premiums eligible?
Yes, the portion covering medical and dental services. The portion covering wage-loss replacement is not. Employer-paid premiums are typically not eligible (already pre-tax to the employee).
What is the refundable medical expense supplement?
A refundable credit (up to $1,534 in 2026) for working low-income claimants with eligible medical expenses. Requires at least $4,478 of earned income; phases out as family net income exceeds $33,960.
Frequently asked questions
- What is the 2026 medical expense threshold?
- The lesser of $2,814 or 3% of net income. Only expenses above this threshold qualify for the credit.
- Which spouse should claim the medical expenses?
- Usually the lower-income spouse, because the 3% net income threshold is smaller, allowing more expenses to qualify.
- Can I use a 12-month period that's not the calendar year?
- Yes. Eligible expenses can be from any 12-month period ending in the tax year, not just January to December. Choose the period that captures the most expenses.
- Are over-the-counter medications eligible?
- No, unless prescribed by a medical practitioner. OTC vitamins, supplements, and pain relievers without prescription do not qualify.
- Can I claim travel for medical appointments?
- Yes, when you travel at least 40 km one way to medical services not available locally. Round trips over 80 km also allow accommodation expenses.
- Can I claim medical expenses for a dependent parent?
- Yes. Expenses paid for a parent, grandparent, sibling, or other dependent relative who was Canadian resident and dependent on you can be claimed on line 33199.
- Are private health insurance premiums eligible?
- Yes for the medical portion of premiums to a private health services plan. The non-medical portion (e.g., dental, vision, drug coverage above the medical norm) is also generally eligible.