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Introduction
The “Non-Invasive Prenatal Test (NIPT)” is a screening method chosen by many pregnant women to gain reassurance. However, because NIPT is usually considered an out-of-pocket service (non-insurance-covered), the cost is not insignificant. For this reason, it is crucial to know whether medical expense deductions can be applied to reduce the financial burden.
This article explains the eligibility requirements for claiming NIPT under medical expense deductions, the application process, and also introduces legal references, tax authority guidance, and relevant case examples.
What Is NIPT? Before Understanding Its Link to Tax Deductions
NIPT (Non-Invasive Prenatal Testing) is an advanced screening test that analyzes fetal DNA in the mother’s blood to detect chromosomal abnormalities such as:
- Trisomy 21 (Down syndrome)
- Trisomy 18 (Edwards syndrome)
- Trisomy 13 (Patau syndrome)
Since NIPT is usually provided as an uninsured medical service, the cost often ranges between ¥100,000–¥200,000. Whether these costs are deductible as medical expenses is a major concern for many expectant mothers and families.
Basic Conditions for Medical Expense Deductions & NIPT Eligibility
What Is a Medical Expense Deduction?
Medical expense deductions allow a partial refund of income tax when annual medical costs exceed a certain amount. The deductible amount is calculated as follows:
Does NIPT Qualify?
Conclusion: Yes, if certain conditions are met, NIPT can qualify.
According to Japan’s National Tax Agency: “Examinations conducted for diagnosis or treatment are deductible as medical expenses.” (Reference: NTA｜No.1122 Eligible Medical Expenses).
Since NIPT is performed under a physician’s direction to assess fetal health and enable medical decisions, it is often accepted as deductible.
When NIPT Qualifies vs. When It Does Not
Eligible Cases
- Test ordered/approved by a physician
- High-risk pregnancy (advanced maternal age, medical history)
- Conducted at institutions offering genetic counseling
- Conducted at certified facilities (e.g., recognized by the Japan Society of Obstetrics and Gynecology)
- Receipts issued with clear “diagnostic purpose” stated
Non-Eligible Cases
- Testing requested for personal preference or non-medical reasons
- Performed without physician involvement or recommendation
- Conducted abroad (deductions typically apply only to domestic medical services)
How to Apply for NIPT Medical Expense Deduction
Step 1: Keep All Receipts
Include NIPT test fees, counseling costs, and public transportation expenses.
Ensure receipts clearly show medical institution name, test type, amount, and payment date.
Step 2: Fill Out the Medical Expense Summary Form
Use the National Tax Agency’s Excel form.
You may include expenses for family members in the same household.
Step 3: Submit via e-Tax or Paper Tax Return
- e-Tax: Receipts not required at submission (but must be kept for 5 years).
- Paper filing: Must submit receipts along with the expense statement.
Filing Period & Key Notes
- Filing period: February 16 – March 15 of the following year
- Refund claims: Can be made retroactively for up to 5 years
- Important: Ambiguous receipts may cause denial; request precise documentation from your medical provider
Practical Examples & Expert Opinions
For instance, an expectant mother undergoing NIPT at a university hospital’s genetics department due to advanced maternal age successfully claimed the deduction, since the test was recognized as medically necessary.
The Japan Society of Obstetrics and Gynecology also emphasizes the significance of prenatal testing when medical risk exists, which can support tax claims.
Common Questions (Q&A)
Q1: If I choose NIPT voluntarily, does it qualify?
A: Generally, no. Without physician involvement or referral, it is often excluded. The key criterion is whether the test serves a diagnostic or treatment purpose.
Q2: Are travel and lodging expenses deductible?
A:
- Public transport fares (bus, train, taxi) are deductible
- Private car fuel/parking is not deductible
- Companion’s travel fare may be deductible if medically necessary
- Lodging costs are generally excluded (except in rare cases)
Importance of Physician Documentation
Supporting documents can strengthen approval chances:
- Physician’s statement noting “NIPT required”
- Referral letters or consent forms
- Counseling records with test purpose and risk explanation
- Detailed receipts and invoices from the medical institution
Common Filing Mistakes Leading to Rejection
- Assuming all private (out-of-pocket) medical services qualify → Cosmetic surgery and routine check-ups do not qualify
- Online-ordered NIPT without physician involvement → Usually not accepted
- Receipt does not mention “NIPT” or “prenatal testing” → May be rejected; request clarification from the medical provider
Overseas NIPT Testing
NIPT conducted overseas may be deductible only if:
- Short-term stay abroad and unavailable in Japan under special circumstances
- Physician referral/diagnosis provided
- Receipt and statement translated into Japanese, clearly describing the test
However, eligibility varies by tax office; consult in advance.
Social Context
Initially, NIPT in Japan was considered a “luxury test for the wealthy,” criticized for its uninsured status. Recently, as demand has grown, medical expense deductions are increasingly seen as fair economic support.
Especially for families facing advanced maternal age or genetic risk, reducing financial burden through tax deductions is becoming more critical.
Conclusion: Understand the Application Process & Use the System Effectively
Although NIPT is costly and not covered by insurance, when conducted under a physician’s diagnostic judgment, it may qualify for medical expense deduction.
By preparing receipts, physician notes, and documentation in advance, you can ensure smooth approval during tax filing.
Medical expense deductions help balance family finances during pregnancy while preparing responsibly for the child’s future.
