Yanta, 2026 TCC 173: unaffordable local treatment does not make travel abroad a medical expense

2026 TCC 173 · Tax Court of Canada

Author: Sas Tullo

This is an informal procedure appeal about the medical expense tax credit. A retired North Bay resident needed full mouth reconstruction that no local dentist could provide, was quoted between $30,000 and $60,000 in Ontario, and instead flew to Antalya for the work at a fraction of the cost. The CRA allowed the dental fees but refused the airfare and hotel. The Tax Court agreed with the CRA: the credit for medical travel depends on whether the trip was objectively reasonable given the services needed and where they were available, and the patient’s ability to pay is not part of that test. Anyone considering medical treatment abroad to save money should read this before counting on a credit for the trip.

Facts

The appellant claimed the credit for amounts paid by her spouse, Mr. Demerse, who lives in North Bay (paras 1-2). His general dentist had recommended treatment by a prosthodontist for a complex full mouth restoration; none practised in North Bay, and the dentist suggested Toronto (para 6). By 2021 Mr. Demerse was missing 13 teeth and had a history of gum infections; Ontario quotes of $30,000 to $60,000 were, in his view, unaffordable (para 7). He chose a clinic in Antalya, Türkiye, with a phased treatment plan (para 8). During a ten-day visit in October 2022 in-house specialists performed bone grafts, a root canal, a sinus lift and six implants with temporary crowns (para 9). He paid 107,506 Turkish lira for the surgery, $4,724.98 for airfare and $2,624.41 for accommodation (para 3). The Minister allowed the treatment cost, converted to $8,536, and disallowed the airfare and accommodation (para 4). Mr. Demerse was the only witness and was found credible (para 24).

Issues

Whether the airfare qualified under paragraph 118.2(2)(g) of the Income Tax Act, which requires that substantially equivalent services were not available locally (subparagraph (iii)), that the route was reasonably direct (subparagraph (iv)), and that it was reasonable, having regard to the circumstances, for the patient to travel to that place (subparagraph (v)); and whether the accommodation qualified under paragraph 118.2(2)(h), which incorporates the same conditions (paras 13-15 and 53).

Holding

The appeal was dismissed without costs (para 56). Substantially equivalent services were not available in North Bay (para 16), and the route was not contested (para 29), but it was not reasonable to travel to Antalya because the services were available in Toronto and other nearby urban centres (para 52). The accommodation therefore failed under paragraph (h) as well (para 54).

The court’s reasoning

The court first addressed subparagraph (g)(iii). Following Tokarski v. The Queen, 2012 TCC 115, at paras 23 and 31, and Young v. The Queen, 2009 TCC 628, at para 9, the affordability of local treatment cannot make it unavailable (para 19); AB v. The Queen, 2014 TCC 157, applied the same approach to fertility treatment sought abroad for cost reasons (para 20). Derksen J. saw no reason not to follow those informal procedure decisions (para 21). The Crown nevertheless failed on the facts. Although the individual procedures were, on their own, standard, Mr. Demerse’s needs were multifaceted and required an interdisciplinary approach under a prosthodontist (paras 25 and 27). No prosthodontist practised in North Bay in 2022, and the Crown did not challenge that evidence in cross-examination (para 26). The treatment was reconstructive rather than cosmetic, so subsection 118.2(2.1) did not exclude it (para 28).

The decision turned on subparagraph (g)(v). The court asked whether affordability could enter the reasonableness analysis, noting that under Tokarski a Toronto patient could not claim travel abroad for cheaper prosthodontics, and asking whether Parliament intended a two-tier result for a North Bay patient with the same needs (paras 31-34). The legislative history reproduced in Tokarski at paras 16-18 and adopted in Canada v. Tallon, 2015 FCA 156, shows that the provision was meant to support rural Canadians travelling to larger centres for specialized services not available at home (paras 35-36). The text of subparagraph (v) is ambiguous as to the relevant factors (para 39). Nothing in the provision limits travel to the closest place where services are provided, which is consistent with the CRA’s long-standing administrative position in a series of technical interpretations (para 43), and nothing requires the services to be provided in Canada, since other paragraphs of subsection 118.2(2) say so expressly when that is intended (para 45).

Even so, the limitations in paragraph (g) cannot be relaxed for sympathetic cases: Tallon at para 39 (para 47). Reading the provision coherently, subparagraph (v) is concerned with the availability and nature of the services the patient needed; it imposes an objective standard under which it may be reasonable to travel far to a centre of expertise, for experimental treatment or in an urgent case (para 50). “The personal affordability of the medical services that a patient requires is not a factor” (para 51). Any other reading would produce the absurd result that a North Bay patient could claim what a Toronto patient in identical circumstances could not, and Parliament is presumed not to intend absurd results: B010 v. Canada, 2015 SCC 58, at para 71; Rizzo & Rizzo Shoes Ltd. (Re), [1998] 1 SCR 27, at para 27 (para 51). Because the same services were available in Toronto and other nearby centres, the trip to Antalya was not reasonable (para 52), and the accommodation failed with it under paragraph (h) (paras 53-54).

Practical implications

The decision fills a gap left by Tokarski. That case held that cost does not make local treatment unavailable under subparagraph (iii) but suggested in obiter that the travel itself would have been reasonable; Yanta closes that door by holding that affordability is equally irrelevant under subparagraph (v). The practical consequence is that medical tourism undertaken to save money will not generate a credit for the travel, even where the patient lives somewhere with no specialist at all. What the patient can still claim is the cost of the treatment itself, which the Minister allowed here under paragraph 118.2(2)(a) (para 55).

In my view the reasoning is sound as a matter of statutory coherence, though the result is hard on rural patients whose choice is between a distant Canadian city and a much cheaper foreign clinic. The court’s reference to the CRA’s technical interpretations is helpful for a different class of claimant: a patient who travels past the nearest specialist to a centre of expertise, or for treatment not offered in Canada, can point to paragraphs 43 to 45 and 50 for the proposition that neither proximity nor a Canadian location is required. The judgment also confirms that the court will look at the treatment plan as a whole, not at each procedure in isolation, when asking whether equivalent services were available locally (para 25). Whether an appeal was taken is not verified here.

If you or a client are planning treatment abroad, separate the two claims. The fees paid to the foreign practitioner remain eligible medical expenses; the flights and hotel are eligible only if a Canadian centre with the needed expertise was not a reasonable alternative for reasons other than price. Keep evidence of why the services were unavailable closer to home, because that, and not the invoice, is what the credit for travel depends on.

This comment is general information, not legal advice. The law may have changed since the decision; check the current text in the tax wiki.

Citation and links

Claire Yanta v. His Majesty the King, 2026 TCC 173, judgment of 18 September 2026 (amended reasons signed 24 September 2026), Derksen J., informal procedure, court file 2024-1667(IT)I. Reasons on the Tax Court’s site. Also on CanLII. This was a first-instance appeal from reassessments of the appellant’s 2022 taxation year; there is no decision under appeal.