Revenue-compliant guidance — Based on Revenue Tax and Duty Manual Part 15-01-12, s.10.6 and Appendix 1 (s.469 TCA 1997). Updated for 2025.
Kidney patients on dialysis receive enhanced health expense allowances under section 10.6 of Revenue’s Tax and Duty Manual and Appendix 1. Hospital dialysis patients claim a mileage allowance for travel to the dialysis centre. Home dialysis and CAPD patients claim flat rates for additional electricity, laundry, and telephone costs. These allowances are in addition to the standard health expense claims for prescription medicines, consultant fees, and other qualifying costs.
What This Page Covers
- The three kidney patient categories: hospital dialysis, home dialysis, CAPD
- Hospital dialysis: the travel mileage allowance — how to calculate and claim it
- Home dialysis and CAPD: the electricity, laundry, and telephone flat rates from Appendix 1
- Prescription medicines for kidney patients as a separate claim
- Home dialysis medical equipment as medical appliances
- Backdating and how to claim in myAccount
Key Facts at a Glance
- ✓Three patient types under s.10.6: hospital dialysis, home dialysis, CAPD — each with different Appendix 1 allowances.
- ✓Hospital dialysis: qualifying mileage to/from the dialysis centre at civil service motor travel rate.
- ✓Home dialysis and CAPD: flat rate allowances for electricity, laundry, and telephone from Appendix 1.
- ✓The fact that the HSE provides dialysis free does not affect the personal cost allowances.
- ✓Prescription medicines and consultant fees claimed separately as standard health expenses.
- ✓Backdate up to four years; keep a journey log for hospital dialysis travel.
Why kidney patients receive enhanced relief under s.10.6
End-stage renal disease requiring dialysis places extraordinary ongoing demands on patients and their families. Hospital dialysis patients typically attend a renal unit three times per week for four hours at a time — roughly 156 sessions per year, every year, indefinitely. Home dialysis and CAPD patients run dialysis equipment in their homes, generating significant additional electricity costs, additional laundry from dialysis-related linen and supplies, and additional telephone communication with the renal team. Revenue’s Tax and Duty Manual, at s.10.6 and Appendix 1, provides specific flat rate allowances to reflect these very real and substantial personal costs without requiring kidney patients to itemise and receipt each individual cost component.
Hospital dialysis patients: the travel mileage allowance
Patients who attend a hospital or renal centre for haemodialysis can claim the cost of travel from home to the dialysis centre and back as a qualifying health expense. Unlike other health expense categories where actual costs are claimed, dialysis travel is typically calculated using the civil service motor travel rate per kilometre, applied to the total annual mileage to and from the dialysis centre.
Calculating the annual qualifying travel amount
To calculate the qualifying annual travel amount:
- Count the number of dialysis sessions attended in the relevant year (typically 3 per week × 52 weeks = 156 sessions, less any hospital admissions or missed sessions).
- Measure the return trip distance from home to the dialysis centre in kilometres.
- Multiply the number of sessions by the return distance to get total annual kilometres.
- Multiply total kilometres by the applicable civil service motor travel rate for that year.
For example: 150 sessions × 50km return = 7,500km × €0.43 (civil service rate) = €3,225 qualifying travel allowance per year. At 20% relief: €645 refund per year from travel alone. Over four backdated years: €2,580.
Keep a contemporaneous journey log recording the date and destination of each dialysis session — or use dialysis centre attendance records (which the renal unit maintains) to verify the number of sessions attended. Revenue may request this documentation in a compliance review.
Where a patient cannot drive
Where a dialysis patient does not drive and uses taxis, HSE transport, or voluntary driver services to attend the dialysis centre, the applicable qualifying cost is the actual fare paid by the patient for each session, where the patient personally paid those costs. Where the HSE or a voluntary organisation funds the transport at no cost to the patient, no personal qualifying expense exists for that travel component.
Home dialysis patients: the Appendix 1 flat rate allowances
Patients who conduct haemodialysis at home rather than attending a renal centre qualify for flat rate allowances set out in Appendix 1 of Revenue’s Tax and Duty Manual. The Appendix 1 allowances for home dialysis patients typically cover three categories:
- Electricity allowance: A flat rate per year reflecting the additional electricity consumed by the home dialysis machine and associated equipment. Home dialysis machines consume significant electricity over multiple sessions per week throughout the year. The Appendix 1 electricity allowance covers this additional running cost without requiring itemised electricity bills.
- Laundry allowance: A flat rate per year reflecting the additional laundry generated by home dialysis — dialysis-related linen, gowns, and clinical supplies that require frequent laundering.
- Telephone allowance: A flat rate per year for telephone communication with the renal care team, home dialysis nursing support services, and the dialysis equipment supplier’s technical support line.
The specific Appendix 1 amounts for each category are published in Revenue’s Tax and Duty Manual Part 15-01-12, Appendix 1. These amounts are revised periodically. Patients should check the current Appendix 1 rates for the relevant claim year at revenue.ie. The combined Appendix 1 allowances for home dialysis patients typically represent a meaningful annual qualifying total when combined with the patient’s standard health expense claims.
CAPD patients: Appendix 1 allowances
Continuous Ambulatory Peritoneal Dialysis (CAPD) patients perform dialysis exchanges throughout the day and night using peritoneal dialysis fluid. CAPD generates its own specific costs — additional electricity for heating dialysis fluid, additional laundry, and telephone communication with the renal team. Appendix 1 provides specific flat rate allowances for CAPD patients, which may differ from the home haemodialysis allowances. Patients should confirm whether they are classified as home haemodialysis patients or CAPD patients, as the applicable Appendix 1 rates differ. Both sets of rates are published in the current version of Revenue’s Tax and Duty Manual Part 15-01-12, Appendix 1.
Prescription medicines and consultant fees as separate claims
The kidney patient Appendix 1 allowances cover the specific additional personal costs of managing dialysis at home or travelling to haemodialysis. They are separate from the standard health expense provisions for prescription medicines and medical consultations. Kidney patients typically have significant annual prescription medicine costs — for patients who have received a kidney transplant, lifelong immunosuppressant medications (tacrolimus, mycophenolate, prednisolone) are particularly significant ongoing prescription costs. All prescribed medicines are claimed as standard health expenses using pharmacy receipts or a pharmacy year-end statement, in addition to the Appendix 1 allowances.
Similarly, renal consultant fees, outpatient nephrology appointment fees, and any other qualifying medical consultation costs are claimed as standard health expenses alongside the Appendix 1 allowances. All of these are entered together as a combined Health Expenses total in myAccount for the relevant year.
Home dialysis equipment as medical appliances
Where a patient purchases home dialysis equipment — haemodialysis machines, water treatment systems, or CAPD warming devices — these qualify as medical appliances under s.3.4 of Revenue’s guidance, where prescribed by a consultant nephrologist. The capital cost of the equipment qualifies in the year of purchase. Consumables — dialysis fluid bags, bloodlines, needles, and other single-use supplies — qualify as ongoing medical appliance consumables in each year they are purchased. Retain the purchase invoices for the equipment and annual invoices for consumables alongside the consultant prescription for the home dialysis programme.
How to claim in myAccount and backdate prior years
After the end of the relevant year, log in to myAccount at revenue.ie. Navigate to PAYE Services → Review your Tax and select the relevant year. Under Health Expenses, enter the total qualifying amount for the year — combining the Appendix 1 flat rate allowances, the travel mileage (for hospital dialysis), standard prescription costs, consultant fees, and any medical appliance costs — as a single Health Expenses total. Retain the journey log, the Appendix 1 rate reference, and all prescription and consultant invoices for six years.
If claims have not been made in prior years, the four-year backdating window allows claims for 2022, 2023, 2024, and 2025 to all be submitted in 2026. For a patient on hospital dialysis with significant annual qualifying costs across travel, prescriptions, and consultant fees, the accumulated four-year refund can be very substantial.
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Check My Entitlement →Scenarios
Scenario: Hospital haemodialysis patient, 3 sessions per week, 40km return journey
A patient attends 150 dialysis sessions per year (3/week, accounting for hospital admissions and bank holidays). Return journey: 40km. Annual qualifying mileage: 150 × 40km = 6,000km × €0.43 = €2,580. Prescription medicines (immunosuppressants plus other medications, not on LTI scheme): €960. Consultant fees (2 outpatient nephrology appointments): €400. Total qualifying health expenses: €3,940. At 20%: €788 refund per year. Over four backdated years: €3,152.
Common Mistakes to Avoid
- ✗Not keeping a dialysis journey log — without a log the travel mileage calculation cannot be verified.
- ✗Not claiming the Appendix 1 flat rate allowances for home dialysis or CAPD — many patients are unaware these exist.
- ✗Not claiming prescription medicines separately — the Appendix 1 allowances and prescription costs are distinct and both qualify.
- ✗Not backdating — for a patient who has been on dialysis for years, the accumulated unclaimed refund across four years can be very significant.
When This Relief Does Not Apply
Key Takeaways
- ➤Hospital dialysis patients: claim mileage at civil service rate for every session, every year.
- ➤Home dialysis and CAPD patients: claim Appendix 1 flat rate allowances for electricity, laundry, and telephone.
- ➤Claim prescription medicines and consultant fees separately — the Appendix 1 allowances do not replace them.
- ➤Backdate four years and keep a journey log going forward.
Frequently Asked Questions
What tax relief is available for kidney patients in Ireland?
Under section 10.6 of Revenue's Tax and Duty Manual Part 15-01-12 and Appendix 1, kidney patients on dialysis receive specific flat rate health expense allowances depending on the type of dialysis they require. Hospital dialysis patients qualify for a mileage allowance for travel to and from the dialysis centre. Home dialysis and CAPD patients qualify for electricity, laundry, and telephone flat rate allowances. All three patient types can also claim standard health expenses (prescription medicines, consultant fees, etc.) in addition to these specific allowances.
Do I need receipts to claim the kidney patient flat rate allowances?
For the flat rate allowances (electricity, laundry, telephone under Appendix 1), no itemised receipts are required — the flat rates are set by Revenue and applied without individual receipt tracking. For the hospital dialysis travel mileage, you need a log of journeys (dates and kilometres) to calculate the qualifying amount. Retain this log for six years.
How is the hospital dialysis travel allowance calculated?
The qualifying mileage allowance is calculated by multiplying the total kilometres travelled to and from the dialysis centre in the year by the applicable civil service motor travel rate per kilometre. A typical dialysis patient attends three times per week — approximately 156 sessions per year. If the return trip is 40km, the annual mileage is 156 × 40km = 6,240km.
Are the kidney patient Appendix 1 allowances updated every year?
The Appendix 1 flat rate amounts are reviewed periodically by Revenue and updated when adjusted. They are not automatically updated every single year but are revised periodically. Patients should check the current Appendix 1 rates in force for the relevant claim year. The current rates are available in Revenue's published Tax and Duty Manual Part 15-01-12.
Can I also claim for my kidney medicines separately?
Yes. Prescription medicines for kidney disease — immunosuppressants for transplant patients, erythropoietin, phosphate binders, and other prescribed medications — qualify as standard health expense prescription medicine claims, entirely separately from the kidney patient flat rate allowances. Include both the flat rate allowances and the actual prescription cost in your total Health Expenses entry in myAccount.
My dialysis is provided by the HSE free of charge — do I still get the flat rate?
Yes. The flat rate allowances under Appendix 1 are intended to compensate for the ongoing personal costs of managing dialysis — travel, additional electricity, laundry burden — rather than the dialysis treatment itself. The dialysis treatment being provided free by the HSE does not affect your entitlement to the flat rate allowances for the associated personal costs.