Medical Tax Credits in South Africa, Explained

If you belong to a medical scheme, SARS gives you a fixed monthly reduction on your tax bill. For the 2026 year of assessment (the tax year ending 28 February 2026, which you file in Filing Season 2026), the Medical Scheme Fees Tax Credit is R364 per month for the main member, R364 per month for the first dependant, and R246 per month for each additional dependant. That is money off your tax payable, automatically, just for being on a medical aid.

There is also a second, less-known credit for big out-of-pocket medical years. Below we explain both, with the reasoning and a worked example, so you know exactly where your number comes from.

What is a medical tax credit? (s6A explained)

The Medical Scheme Fees Tax Credit (section 6A) is a fixed monthly rebate you get for paying into a registered medical scheme. It is set by SARS in Rands per month – it does not change based on how much your contributions cost, only on how many people are covered.

For the 2026 year of assessment, the SARS monthly amounts are:

Who is covered	Credit per month
Main member	R364
First dependant	R364
Each additional dependant	R246

Two things matter about how this works:

It is non-refundable. The credit reduces the tax you owe; it does not reduce your taxable income, and it cannot create a refund on its own. If your tax payable is already zero, the credit has nothing to subtract from.
It is a rebate, not a deduction. A deduction lowers the income you are taxed on; this rebate comes off the tax itself, rand-for-rand.

Worked example – a family of four. Suppose you are the main member, with a spouse and two children on your scheme:

Main member: R364
First dependant (spouse): R364
Additional dependant (child 1): R246
Additional dependant (child 2): R246

That is R1,220 per month, or R14,640 over the full 12 months – taken straight off your tax for the year. If your employer already runs your medical aid through payroll, much of this is usually applied to your monthly PAYE so you feel it during the year rather than only at assessment.

Heads-up for next year: from 1 March 2026 (the 2027 year of assessment), SARS increases these amounts to R376 for the main member, R376 for the first dependant, and R254 for each additional dependant. Those new figures do not apply to the 2026 return you are filing now.

The Additional Medical Expenses Tax Credit (s6B) – for big out-of-pocket years

The Additional Medical Expenses Tax Credit (section 6B) is the more complex credit. It exists for the costs your scheme did not cover – qualifying out-of-pocket expenses you paid yourself – plus any "excess" medical scheme contributions. This is the part most people get wrong, so it is worth using a calculator rather than doing it by hand.

How it is worked out depends on your age and disability status.

If you are under 65 with no disability, the s6B credit is:

25% of [ (your medical scheme contributions that exceed 4× your s6A credits) plus your qualifying out-of-pocket expenses ] minus 7.5% of your taxable income.

Only the amount above the 7.5%-of-taxable-income threshold counts. In a normal year, most under-65 taxpayers without a disability get nothing here – the threshold is high on purpose. It is designed to help in years of unusually large medical spending.

If you are 65 or older, OR you, your spouse or your child has a disability, the rules are more generous and there is no 7.5% threshold:

33.3% of [ your medical scheme contributions that exceed 3× your s6A credits ] plus 33.3% of your qualifying out-of-pocket expenses.

In short: the s6B credit rewards either a very heavy medical-spend year (under-65, no disability) or membership in a protected group (65+, or disability). Because the inputs – excess contributions, qualifying expenses, taxable income – interact, this is exactly where a calculator earns its keep.

Who can claim, and how (eFiling, ITR12, your tax certificate)

You can claim medical tax credits if you are the person who paid the medical scheme contributions and/or the out-of-pocket expenses, for yourself and your dependants. You generally claim on your annual ITR12 income tax return via SARS eFiling.

To claim correctly, keep these documents:

Your medical scheme tax certificate (issued by your scheme after the tax year), showing total contributions and the number of dependants per month.
Receipts and statements for qualifying out-of-pocket expenses not recovered from the scheme.
For disability claims, a completed ITR-DD (Confirmation of Diagnosis of Disability) form from a registered medical practitioner.

If your medical aid runs through your employer, your s6A credit may already be reflected in your monthly PAYE, but you should still confirm it on your ITR12. SARS often pre-populates medical scheme data – always check it against your own certificate before you submit.

A worked example (showing the reasoning)

Let's stay with the main member + spouse + 1 child, and walk the logic end to end for the 2026 year.

Step 1 – the s6A credit (the easy part).

Main member: R364
First dependant (spouse): R364
Additional dependant (child): R246
Monthly total: R974, which is R11,688 for the full 12 months.

That R11,688 comes straight off this taxpayer's tax payable for the year.

Step 2 – the s6B credit (the threshold part). Assume the taxpayer is under 65 with no disability. To test for an s6B credit, you would:

Take medical scheme contributions and subtract 4 × the annual s6A credits – only contributions above that line count.
Add any qualifying out-of-pocket expenses paid during the year.
Take 25% of that combined figure.
Subtract 7.5% of taxable income. Whatever remains above zero is the s6B credit.

The reasoning: SARS first assumes a "normal" level of medical scheme cost (the 4× figure) and a normal level of total medical spend (the 7.5% line). Only spending beyond those baselines earns an extra credit. In a typical year this may come to R0 – and that is correct, not a mistake. It only kicks in when your real medical costs run well above the norm.

The exact rands depend on the contributions, out-of-pocket expenses and taxable income you enter – which is why we show every line of this calculation in the tool rather than just handing you a total.

✅ Figures confirmed against SARS (15 June 2026): the 2026-YoA s6A credits are R364 / R364 / R246; the increase to R376 / R376 / R254 takes effect 1 March 2026 (the 2027 year of assessment), per Budget 2026. SARS – Medical Tax Credit Rates.

Frequently asked questions

What is the medical tax credit for 2026 in South Africa? For the 2026 year of assessment (year ending 28 February 2026), the SARS Medical Scheme Fees Tax Credit is R364 per month for the main member, R364 for the first dependant, and R246 for each additional dependant.

Is the medical tax credit a deduction or a rebate? It is a rebate. It reduces your tax payable directly, rand-for-rand – it does not reduce your taxable income the way a deduction does.

Can I get a refund from the medical tax credit? The s6A credit is non-refundable, so on its own it cannot create a refund – it can only reduce tax you owe down to zero. You may still receive a refund overall if, for example, your PAYE for the year was more than your final tax liability.

What is the difference between the s6A and s6B medical credits? The s6A credit is the fixed monthly amount for being on a medical scheme. The s6B (Additional Medical Expenses) credit is an extra credit for high out-of-pocket costs and excess contributions, and it depends on your age, disability status and taxable income.

Do the medical tax credit amounts change in March 2026? Yes. From 1 March 2026 (the 2027 tax year), the amounts rise to R376 for the main member, R376 for the first dependant, and R254 for each additional dependant. These do not affect your 2026 return.

See your exact medical tax credit

Don't guess – and don't settle for a single number with no explanation. Our Medical Credits calculator works out both your s6A and s6B credits for the 2026 year and shows you every line of the reasoning: how many dependants, where the 4× and 7.5% thresholds land, and exactly why your number is what it is. Want the full picture across your whole return? Try the Comprehensive calculator, and if you also get a car allowance, see our guide to the travel allowance and tax in South Africa.

SARS sources: