Medical Tax Credits South Africa 2026: How to Maximize Your Savings

Medical scheme contributions are one of the largest monthly expenses for many South African families. The good news is that SARS provides a tax credit system that helps offset this cost. The bad news is that many taxpayers do not fully understand how the system works and may be leaving money on the table — particularly when it comes to the additional medical expenses credit for out-of-pocket healthcare costs.

This guide explains both components of the medical tax credit system and shows you how to maximise your savings for the 2026/2027 tax year.

Section 6A: Medical Scheme Fees Tax Credit

The primary medical tax credit is a fixed monthly amount that reduces your PAYE (Pay As You Earn) tax. For 2026/2027, the monthly credits are:

• Main member: R364 per month
• First dependant: R364 per month
• Each additional dependant: R246 per month

For a family of four (main member, spouse, and two children), the total monthly credit is R364 + R364 + R246 + R246 = R1 220 per month, or R14 640 per year. This is a direct reduction of your tax bill — not a deduction from taxable income.

The credit applies regardless of how much your medical scheme actually costs. Whether you pay R2 000 or R10 000 per month in medical scheme contributions, the tax credit remains the same. This means the credit covers a larger proportion of cheaper scheme options and a smaller proportion of comprehensive plans.

Your employer should automatically apply this credit to your monthly PAYE calculation. Check your payslip to confirm it is being applied correctly, and use our medical tax credits calculator to verify the amounts.

Section 6B: Additional Medical Expenses Tax Credit

This is where many taxpayers miss out. Section 6B provides an additional credit for qualifying medical expenses that you paid out of your own pocket — amounts not covered by your medical scheme. This includes:

• Co-payments and shortfalls on medical scheme claims
• Expenses incurred during medical savings account depletion
• Prescribed medications purchased out-of-pocket
• Dental work not covered by your plan
• Optometry expenses (eye tests, glasses, contact lenses)
• Physiotherapy, occupational therapy, and similar treatments
• Expenses for disabled persons (qualifying for a higher credit rate)

The additional credit is calculated differently depending on your age:

If you are under 65 and not a person with a disability:

• 25% of (qualifying medical expenses minus 4 times the Section 6A credit)
• This means your out-of-pocket expenses must exceed four times your Section 6A credit before you get any additional benefit
• For a family of four with R14 640 in annual Section 6A credits, your out-of-pocket expenses must exceed R58 560 before the Section 6B credit kicks in

If you are 65 or older:

• 33.3% of qualifying medical expenses (no threshold to exceed)
• Plus 33.3% of (medical scheme contributions minus 3 times the Section 6A credit)

The over-65 formula is significantly more generous, reflecting the higher healthcare costs typically faced by older taxpayers.

Claiming on Your Tax Return

Section 6A credits are applied automatically through your PAYE. Section 6B credits, however, must be claimed on your annual income tax return (ITR12). To do this:

1. Keep all receipts for out-of-pocket medical expenses throughout the tax year
2. Obtain your medical scheme tax certificate (showing contributions and claims) — your scheme sends this automatically, usually by June
3. Enter the details in the medical section of your ITR12 on SARS eFiling
4. SARS will calculate the additional credit and include it in your assessment

Many taxpayers do not claim Section 6B because they do not keep receipts or do not realise these expenses qualify. The amounts can be significant — a family with R80 000 in qualifying out-of-pocket expenses could receive an additional credit of several thousand rands.

Strategies to Maximise Medical Tax Credits

• Keep every medical receipt. Even small expenses add up over a year. Pharmacy receipts, optometrist bills, dental invoices — keep them all.
• Choose your medical scheme wisely. A cheaper scheme with higher co-payments may result in more out-of-pocket expenses, which can be partially offset by Section 6B credits. Run the numbers with our medical tax credits calculator.
• Consolidate family medical expenses. Ensure all dependant expenses are claimed under the main member's return for maximum credit calculation.
• File your tax return. If you do not file, you cannot claim Section 6B credits. Even if your employer handles your PAYE, filing a return can unlock additional refunds.

Combine medical credits with other tax-saving strategies using our salary calculator and retirement fund calculator for a complete picture.

Key Takeaways

• Section 6A provides fixed monthly credits of R364 per member (main + first dependant) and R246 per additional dependant.
• Section 6B provides additional credits for out-of-pocket medical expenses — but only if they exceed a threshold for taxpayers under 65.
• Over-65 taxpayers benefit from a much more generous formula with no threshold.
• Keep all medical receipts and claim on your ITR12 to access Section 6B credits.
• Use our medical tax credits calculator to estimate your total credit.