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VAT exemption in healthcare: when does it apply and when not?
Written by Ilias5 min read
For many healthcare freelancers the VAT exemption is a given. Yet care providers regularly run into questions: does the exemption apply to everything I do? And what if I also offer something else? A wrong assessment can lead to additional assessments. In this article we zoom in on when the care exemption applies and when you do have to charge VAT.
Which care is exempt?
The exemption applies to the medical care of people by practitioners of a medical or paramedical profession that falls under the BIG Act. Think of nurses, physiotherapists and carers. The core is that the service is aimed at the patient's health. If that's the case, you don't charge VAT.
Certain forms of support and home care also fall under the exemption, as long as they have a care character. If you doubt whether your service qualifies, it's wise to have it checked, because the tax authorities look at the content of the service, not just your profession.
When do you charge VAT?
Not everything a care provider does is exempt. If you give training, lectures or advice that isn't directly aimed at the health of an individual patient, that's often taxed at 21 percent VAT. The same applies to coaching without a medical basis or selling products.
If you have both exempt and taxable services, you're partly liable for VAT. You then have to make a split and declare VAT on the taxable part. The input VAT belonging to that taxable part can be reclaimed. This requires careful bookkeeping.
Avoid additional assessments
The most common mistake is assuming everything is exempt. So map out which services you provide and whether they have a care character. If you doubt a new service, check before you invoice.
A bookkeeper with experience in healthcare can help you with this and prevents you from having to pay VAT afterwards. That way you keep your bookkeeping correct and your mind on your work.
This article provides general information based on the rules known for 2026 and does not replace personal tax advice. For your specific situation, we're happy to take a look with you.
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