Medical tax credits

The fast answer: your medical tax credit is not a deduction off your income – it's a credit that comes straight off your tax owed. Enter your medical-aid members and your out-of-pocket medical bills, and the calculator below applies both halves of the SARS rules for the 2026 year of assessment: the fixed section 6A medical scheme fees credit (R364 for you, R364 for your first dependant, R246 for each one after that, per month) and the section 6B additional credit that may apply on top for excess scheme fees and out-of-pocket expenses. The result is the rand amount your assessment is reduced by – calculated, not guessed.

Open the medical tax credit calculator →

New to how this works? Read the full Medical tax credits explained guide first – this page is the calculator.

What the calculator works out

A medical tax credit is fundamentally different from a deduction. A deduction lowers your taxable income; a credit is subtracted from your tax, rand for rand. That's why two people on very different salaries get the same scheme-fees credit – it doesn't depend on your marginal rate. The calculator splits your credit into the two parts SARS uses:

1. Section 6A – the medical scheme fees tax credit (the fixed part). A set monthly amount for everyone who belongs to a registered medical scheme, regardless of what you actually pay in contributions. For the 2026 year:

Member	Monthly credit
Main member	R364
First dependant	R364
Each additional dependant	R246

So a family of four – main member, spouse and two children – earns (R364 + R364 + R246 + R246) × 12 = R14,640 off their tax for the year. The calculator multiplies your member mix by 12 automatically.

2. Section 6B – the additional medical expenses tax credit (the variable part). This catches the money your scheme didn't cover: out-of-pocket bills, plus any contributions that ran well ahead of your s6A credit. How it's calculated depends on your situation, and the calculator picks the right branch:

• Under 65, no disability: SARS takes your qualifying out-of-pocket expenses plus the part of your scheme fees that exceeds four times your s6A credit, then allows 25% of whatever is left after subtracting 7.5% of your taxable income. The 7.5% floor is high, so most healthy under-65s get little or no s6B credit – which is exactly the reasoning worth seeing rather than assuming.
• 65 and older: the threshold falls away. You get 33.3% of your scheme fees above three times your s6A credit, plus 33.3% of your out-of-pocket expenses.
• Disability (you, your spouse or your child): same generous formula as the 65+ case – 33.3% above the three-times line plus 33.3% of qualifying expenses, with no 7.5% threshold.

The calculator shows each line so you can see whether your out-of-pocket spending actually cleared the threshold, not just the final figure.

Worked example (show the workings)

Lerato is under 65, no disability. She and her two children are on a medical scheme. She paid R36,000 in scheme contributions for the year and R18,000 in out-of-pocket bills the scheme didn't cover. Her taxable income is R400,000.

Section 6A (fixed): main member R364 + first dependant R364 + one additional dependant R246 = R974/month × 12 = R11,688.

Section 6B (additional), under-65 branch:

• Four times her s6A credit: R11,688 × 4 = R46,752. Her contributions (R36,000) are below that, so none of her scheme fees count toward s6B. Excess scheme fees = R0.
• Add out-of-pocket: R0 + R18,000 = R18,000.
• Subtract 7.5% of taxable income: 7.5% × R400,000 = R30,000. R18,000 − R30,000 = −R12,000 → floored at R0.
• 25% × R0 = R0 additional credit.

Total medical tax credit: R11,688, all from section 6A. Lerato's out-of-pocket bills didn't clear the 7.5% floor, so they added nothing – the kind of result that's far better to see calculated than to discover on assessment. Had she been 65 or had a disability in the family, that R18,000 would instead have yielded 33.3% × R18,000 = R5,994 on top, because the threshold wouldn't apply.