Exempt health benefits: eye tests, flu jabs and screening

Employers can provide or pay for one health screening assessment and one medical check up a year, eye tests and screen glasses for display screen users, flu jabs, and up to £500 a year of recommended treatment to help someone back to work, all without tax or National Insurance. Each exemption has its own conditions, and anything outside them, such as private medical insurance or general treatment, is a taxable benefit.

Which health benefits are exempt from tax?

Most medical help an employer gives is taxable. HMRC’s Employment Income Manual at EIM21760 explains that where an employer pays for treatment or pays premiums on a medical insurance policy covering employees, a benefit charge arises under Part 3 Chapter 10 of the Income Tax (Earnings and Pensions) Act 2003 (ITEPA). Against that background, Part 4 of ITEPA carves out a short list of specific exemptions:

Benefit	ITEPA section	Main limit or condition
Eye tests and glasses for screen work	s320A	Test required under health and safety rules; glasses needed solely for screen use
Health screening and medical check ups	s320B	One of each per tax year
Recommended medical treatment	s320C	Up to £500 per employee per tax year, after 28 days of absence or unfitness
Flu vaccinations	s320D	From 6 April 2026; not under salary sacrifice
Treatment needed while working abroad	s325	Need arises while abroad on duties

GOV.UK’s employer guidance on medical or dental treatment and insurance confirms that where these apply you do not have to report anything to HMRC or pay tax and National Insurance. Treatment or insurance for injuries or diseases that result from the employee’s work is also exempt, which is a separate rule and is not covered here.

When are eye tests and glasses tax free?

Section 320A covers staff who use a screen as part of their normal duties. Under regulation 5 of the Health and Safety (Display Screen Equipment) Regulations 1992, an employer must, if a user asks, arrange an appropriate eye and eyesight test by a competent person, and provide further tests at regular intervals. HMRC’s guidance at EIM21765 says no taxable benefit arises on:

• an eyesight test required under those health and safety rules, and
• spectacles or contact lenses needed solely for screen use, where the test shows they are necessary.

The tests and corrective appliances must be available generally to all employees, although glasses only need to be offered where the test shows them to be needed. If an employee’s ordinary glasses include a special prescription for screen use, only the proportion of the cost relating to that special prescription is exempt. Ordinary glasses that the employee also happens to wear at a screen are a taxable benefit.

Until 5 April 2026 the income tax exemption only covered direct provision. From 6 April 2026 EIM21765 confirms it also covers the employer paying or reimbursing the employee’s own costs, subject to the same conditions. HMRC’s April 2026 Employer Bulletin says reimbursements made for tests bought before that date fall under the previous rules and are generally taxable unless another exemption applies.

What counts as health screening or a medical check up?

Section 320B exempts the cost of health screening assessments and medical check ups, limited from 6 April 2009 to one of each in a tax year. EIM21765 draws the distinction:

Health screening assessment

An assessment to identify employees who might be at particular risk of ill health, such as a lifestyle questionnaire or telephone interview used to decide who should be invited for a check up.

Medical check up

A physical examination by a health professional for, and only for, the purpose of determining the employee’s state of health.

An employee does not have to go through screening first to get an exempt check up. The exemption also covers a non cash voucher or credit token given to obtain the screening or check up. Three limits catch people out. First, checks connected to the provision of medical treatment are not covered. Second, check ups for family members are taxable unless that person is also an employee of the same employer. Third, where someone holds several employments at once, for example as a director of several companies in a group, the one per year limit applies across the group as a whole.

Are flu jabs exempt?

Yes. Finance Act 2026 inserted section 320D into ITEPA for 2026 to 2027 onwards. The section says no income tax arises on an influenza vaccination provided for an employee, or on the payment or reimbursement of the employee’s own expenses for one, as long as it is not provided under relevant salary sacrifice arrangements. HMRC’s guidance at EIM21874 adds that the exemption applies whether the employer arranges the vaccination, pays the provider, issues a voucher or reimburses the employee, and that it does not extend to vaccinations for family or household members.

HMRC’s policy paper on expanding workplace benefits relief explains why the change was made: before April 2026 employers could not simply reimburse a flu jab tax free and instead had to use voucher schemes. A matching Class 1 National Insurance disregard was introduced at the same time.

How does the £500 recommended treatment exemption work?

Section 320C, in force from 1 January 2015, lets an employer fund medical treatment that helps an employee return to work. EIM21774 sets out four conditions, all of which must be met:

1. Before the recommendation, the employee has been assessed by a health care professional as unfit for work because of injury or ill health for at least 28 consecutive days, or has actually been absent for at least 28 consecutive days.
2. The recommendation is made by a health care professional as part of occupational health services, either under section 2 of the Employment and Training Act 1973 or under arrangements made by the employer.
3. The recommendation is made to help the employee return to work.
4. The recommendation is in writing, given to both employer and employee, and specifies the treatment.

The cap is £500 per employee per tax year. Anything above it is taxed in the normal way for medical treatment, and the exemption does not apply where the treatment is provided under salary sacrifice. EIM21775 lists who counts as a health care professional: a registered medical practitioner, a registered nurse, or an occupational therapist, physiotherapist or psychologist registered with a body regulated under section 60 of the Health Act 1999.

What health benefits remain taxable?

Private medical insurance is the obvious one. EIM21762 confirms that an employee is chargeable on premiums the employer pays to cover them or their family, less anything they make good. General treatment the employer pays for is also taxable. The GOV.UK guidance sets out how to deal with it:

• if you arrange and pay the provider directly, report it on form P11D and pay Class 1A National Insurance on the cost;
• if the employee arranges the treatment but you pay the provider, report it on P11D and include the value in earnings for Class 1 National Insurance, but not PAYE tax;
• if you reimburse the employee, the payment is earnings and goes through payroll for both PAYE and Class 1 National Insurance.

The P11D, Class 1A and payrolling mechanics are covered in our guides to benefits in kind and the P11D, Class 1A National Insurance and payrolling benefits in kind.

Does salary sacrifice affect these exemptions?

Usually, yes. The GOV.UK guidance says medical or dental treatment or insurance provided under a salary sacrifice arrangement must be reported. Section 320D excludes flu jabs bought through salary sacrifice, and EIM21774 says the same of recommended treatment. Under the optional remuneration rules described at EIM44130, an otherwise exempt benefit taken in exchange for salary is valued at the salary given up. See our page on salary sacrifice schemes for the wider rules.

A worked example

Illustration only. A firm with 20 office staff does four things in the 2026 to 2027 tax year:

• It reimburses an employee £25 for a screen user eye test she booked herself in May 2026, and £60 for glasses the optician says she needs only for screen work. Both are exempt under the extended section 320A.
• It reimburses each employee who has a flu jab at a pharmacy. Exempt under section 320D.
• It pays for one annual check up for each employee and their partner. The employee’s check up is exempt; the partner’s is a taxable benefit for the employee.
• After an employee has been off for six weeks with a back injury, an occupational health physiotherapist gives a written recommendation for a course of treatment costing £650. The first £500 is exempt; £150 is taxable.

What mistakes come up most often?

• Treating ordinary glasses as exempt because the employee uses a screen. Only the screen specific element qualifies.
• Paying for a second check up in the same tax year, or for check ups across several group companies, and treating them all as exempt.
• Applying the new reimbursement rules to costs incurred before 6 April 2026.
• Paying for treatment before a written recommendation exists, or without the 28 day test being met, and then relying on section 320C.
• Assuming anything health related is exempt. A gym membership, private medical insurance or a family member’s flu jab is not.

Keep the occupational health recommendation, the eye test report showing screen glasses are needed, and records of who received which check up, so the conditions can be shown to have been met if HMRC opens an employer compliance check.

If HMRC opens a check into your return, tax investigation insurance pays your accountant’s fees. Solar Protect cover pays up to £100,000 with no excess; it never pays tax, interest or penalties. Read how our cover works or get a quote.

Related Accountapedia entries

• Private medical insurance as a benefit in kind
• The £500 recommended medical treatment exemption
• Counselling services for staff: tax treatment
• Employer paid home broadband: is it taxable
• Tax on income protection and sick pay insurance

Sources

• GOV.UK: Manual page EIM21760
• GOV.UK: Print
• GOV.UK: Manual page EIM21765
• legislation.gov.uk: SI 1992/2792, regulation 5
• GOV.UK: April 2026 issue of the employer bulletin
• legislation.gov.uk: Act 2003 c. 1, section 320D
• GOV.UK: Manual page EIM21874
• GOV.UK: Expanding workplace benefits relief
• GOV.UK: Manual page EIM21774
• GOV.UK: Manual page EIM21775

Reviewed by Christine Anderson, Broker, Solar Protect. Last reviewed 8 October 2026. Part of Accountapedia, the Solar Protect guide to UK tax and accounting. This page is general information, not personalised advice.