Medical Tax Credit in South Africa: How It Works

South Africa’s medical tax credit reduces the tax you owe, not your taxable income. For the 2024/2025 tax year, SARS sets the section 6A credit at R364 per month for the main member and first dependant on the scheme, and R246 per month for each additional dependant (SARS: Medical Tax Credits, 2024). Knowing the exact amounts lets you verify your assessment rather than accept the pre-populated figure without question.

Key Takeaways

The 2024/2025 medical tax credit is R364/month for the main member and first dependant, R246/month for each additional dependant (SARS).

Credits reduce tax owed directly, not taxable income - the rand value is the same regardless of your bracket.

Additional relief under s6B of the Income Tax Act applies if you’re 65 or older, or have a qualifying disability.

Always compare the pre-populated credit on your ITR12 against your scheme’s annual tax certificate before filing.

What is the medical tax credit?

Section 6A of the Income Tax Act 58 of 1962 grants a fixed credit per month for contributions to a registered medical scheme (legislation.gov.za). For the 2024/2025 tax year, the monthly amounts are R364 for the main member, R364 for the first additional dependant, and R246 for each subsequent dependant beyond that. The credit reduces your final tax bill, not your taxable income.

A deduction saves you more in tax if you’re on a higher bracket - it reduces the income taxed at your marginal rate. A credit skips that logic. Whether you earn R200,000 or R2,000,000, you get the same rand amount off your tax bill for the same number of dependants.

Section 6B of the same Act covers supplementary medical expense relief for taxpayers aged 65 and over, or those with a qualifying disability. The s6B credit is calculated at 33.3% of the excess - meaning 33.3% of qualifying out-of-pocket expenses that exceed three times the s6A credit received in the year (SARS Medical Expenditure Guide).

What qualifies for the credit?

Medical scheme contributions - s6A

Monthly contributions to a scheme registered under the Medical Schemes Act 131 of 1998 qualify for the main monthly credit. The credit applies to the main member and each registered dependant at the applicable per-person amount. Contributions above the standard credit threshold don’t automatically generate additional relief unless you qualify under s6B.

Out-of-pocket expenses - s6B

If you’re 65 or older, or have a qualifying disability, you may claim additional relief on medical expenses your scheme didn’t reimburse. Qualifying costs include prescribed medicines, specialist consultations, and certain disability-related expenditure. SARS publishes a detailed list at sars.gov.za/individuals/medical/.

If you’re under 65 without a disability, out-of-pocket relief only applies once expenses exceed 7.5% of your taxable income - and even then, only 25% of the excess qualifies. In practice this threshold rarely benefits salaried employees on standard income.

What proof does SARS need?

Your medical scheme issues an annual tax certificate, usually by mid-February, setting out total contributions paid and what the scheme submitted to SARS. This certificate is the primary document for the s6A credit. SARS pre-populates some ITR12 fields using data submitted by schemes, but that figure may not match what you actually paid, especially if your cover or dependants changed during the year.

Keep the following documents for at least five years (SARS record-keeping):

Annual tax certificate from your medical scheme
Invoices for out-of-pocket medical expenses
Bank statements or receipts confirming payment
Scheme statements showing what was reimbursed vs. what you paid yourself
Dependant registration confirmations

Common mistakes

Treating contributions as a standard income deduction. Medical scheme contributions aren’t deducted from taxable income - they generate a fixed credit applied after tax is calculated. Conflating the two leads to incorrect self-assessment of tax owed.

Claiming all out-of-pocket expenses. Only taxpayers aged 65+, those with qualifying disabilities, or those whose expenses exceed the 7.5% income threshold can claim additional medical expense relief. Most employees under 65 without a disability get no additional credit on out-of-pocket costs.

Accepting pre-populated errors. SARS uses data submitted by your medical scheme to pre-populate the credit. If the scheme reported incorrectly, your assessment will reflect the wrong amount. Always reconcile the pre-populated credit against the scheme’s annual tax certificate before filing.

Frequently Asked Questions

How is the medical tax credit different from a normal deduction?

A medical tax credit reduces the tax you owe, not your taxable income. The 2024/2025 credit of R364 per month for the main member saves the same R364 in tax regardless of your income bracket. A deduction, by contrast, is worth more to higher earners because it reduces income taxed at the marginal rate. Medical scheme contributions use the credit mechanism, not the deduction system.

Is medical aid fully tax deductible?

No. Medical scheme contributions qualify for a fixed monthly credit - R364 for the main member and first dependant, R246 for additional dependants in 2024/2025 - applied directly against your tax liability. This isn’t a percentage deduction from taxable income. Additional relief under s6B applies only to those aged 65+, those with qualifying disabilities, or those meeting the 7.5% out-of-pocket expense threshold.

What if I paid medical costs out of pocket that my scheme didn’t cover?

If you’re under 65 without a disability, additional credit only kicks in once qualifying out-of-pocket expenses exceed 7.5% of your taxable income - then only 25% of the excess counts. If you’re 65+, or have a qualifying disability, section 6B applies: 33.3% of qualifying expenses above three times your s6A credit for the year. Full eligibility rules are at sars.gov.za/individuals/medical/.

What if the SARS pre-populated medical credit looks wrong?

Compare the pre-populated amount on your ITR12 against your medical scheme’s annual tax certificate. The certificate shows exactly what contributions the scheme reported to SARS for the year. If the figures differ, contact your scheme first to verify what they submitted. If the scheme confirms their data is correct and the return still shows a different amount, contact SARS with the certificate as supporting evidence. Don’t file without resolving the discrepancy.

Sources

SARS: Medical Tax Credits - official credit amounts, qualifying expenses, and updated guidance for each tax year
Income Tax Act 58 of 1962, sections 6A and 6B - legislative basis for the medical credit and supplementary expense relief
SARS Comprehensive Guide to Medical Expenditure - detailed list of qualifying out-of-pocket expenses

This guide is for general educational purposes only. Credit amounts are set annually - verify current figures at sars.gov.za before filing.