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Home › Medical Aid Tax Credit SA 2026

Medical Aid Tax Credits South Africa 2026 — What You Can Claim

The 2026 medical tax credit amounts, how they reduce your PAYE, and the additional out-of-pocket medical deduction most South Africans miss.

Main member credit

R364/month

Per dependant

R246/month

Family of 4 (annual)

~R13,224

Out-of-pocket threshold

7.5% of income

Medical Aid Tax Credit (Section 6A) — 2025/2026

Members on Medical AidMonthly CreditAnnual Credit
Main member onlyR364R4,368
Main member + 1 dependantR610R7,320
Main member + 2 dependantsR856R10,272
Main member + 3 dependantsR1,102R13,224
Main member + 4 dependantsR1,348R16,176

Section 6B — Out-of-Pocket Medical Deduction Example (Under 65)

ItemAmount
Taxable incomeR360,000
7.5% thresholdR27,000
Out-of-pocket qualifying medical expensesR35,000
Amount above threshold (deductible)R8,000
Tax credit at 25% of deductible amountR2,000 credit
(Over 65 or disabled — 33.3% credit, no threshold)More generous

How Medical Aid Tax Credits Work in Practice

Medical aid tax credits work differently from most tax deductions. A deduction reduces your taxable income (and saves you tax at your marginal rate). A credit reduces your tax bill directly, rand for rand, regardless of your income level. This makes credits especially valuable to lower-income earners — R364 in monthly credits saves exactly R4,368 in tax per year whether you're in the 18% or 41% bracket.

Your employer should factor in your declared medical aid dependants when calculating PAYE each month. If you're on a medical scheme with three dependants and your employer applies the full R1,102/month credit, your PAYE is reduced by R1,102 every month — that's R13,224 per year less in tax deducted from your salary. If they don't apply it, you'll get it as a refund at year-end when you file your return.

Important: if you're not a member of a registered medical aid scheme but you pay medical expenses directly (cash patients), you cannot claim the Section 6A credit. The credit is specifically for medical scheme contributions. However, those out-of-pocket expenses may qualify under Section 6B if they're above the 7.5% threshold.

Medical Expenses That Qualify for Section 6B Deduction

Section 6B catches a wide range of qualifying medical expenses. The key requirement is that the expense must be for a 'qualifying medical expense' as defined by SARS, and it must not have been reimbursed by your medical aid. Qualifying expenses include: doctor and specialist consultation shortfalls (co-payments); dental work not fully covered; optical expenses (spectacles, contact lenses, eye tests); prescribed medication not on your scheme's formulary; hospital co-payments and hospital admissions above your plan's limit; mobility aids, hearing aids, and other qualifying disability-related expenses.

Non-qualifying expenses include: gym memberships, vitamins and supplements (unless prescribed), cosmetic procedures, elective surgeries that are clearly not medically necessary, and any expense reimbursed by your medical scheme. If in doubt, keep the receipt and let your tax practitioner decide.

For taxpayers with a disability or those over 65, the Section 6B rules are significantly more generous. Under 65 and no disability: only expenses above 7.5% of taxable income are claimable. Over 65 or with a disability (ITR-DD approved): 33.3% of all qualifying expenses are deductible with no 7.5% threshold. This is a meaningful benefit for older South Africans with significant medical costs.

Frequently Asked Questions

For the 2025/2026 tax year: R364/month for the main member (taxpayer); R246/month for the first dependant; R246/month for each additional dependant. Annual totals: Main member: R4,368. Add one spouse: R7,320/year. Add two children: R13,224/year. These credits directly reduce your tax bill — not your taxable income.
Section 6A is the Medical Aid Tax Credit (MTC) — the fixed monthly credit applied per member. Section 6B is the additional deduction for out-of-pocket medical expenses not reimbursed by medical aid, above a threshold of 7.5% of taxable income (for taxpayers under 65). For those over 65 or with disabilities, more generous rules apply — the 7.5% threshold doesn't apply.
Yes — any qualifying medical expenses you paid yourself that were not reimbursed by your medical aid can potentially be claimed under Section 6B. This includes: co-payments, dentistry, optometry, chronic medication gaps, specialist shortfalls. But only the amount exceeding 7.5% of your taxable income is deductible (under 65). Keep all receipts.
Your employer should apply the MTC monthly when calculating PAYE, reducing the tax deducted from your salary. This requires that you inform your employer how many dependants are on your medical aid. If your employer doesn't apply the credit, you'll receive the benefit as a refund when filing your annual return — so you don't lose it, it's just delayed.
No medical aid tax credit (Section 6A) — those are specific to medical scheme contributions. But if you pay for medical expenses out of pocket (private doctor visits, medication, hospital visits), those may qualify under Section 6B, though the 7.5% threshold still applies. Below 7.5% of taxable income, there's no deduction at all.

Related Tools & Guides

SARS eFiling Guide How PAYE Works Tax Threshold 2026 Medical Aid Guide 2026 Business Tax Estimator

Disclaimer: This page is for informational purposes only and does not constitute financial, tax, or legal advice. Always consult a qualified professional before making financial decisions.

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