Medical Aid Tax Credits in South Africa: How Much You Get, and the Extra One Most People Miss

If you pay for a medical scheme in South Africa, SARS quietly hands some of it back every year. Most people know about the basic credit, the fixed amount that lowers your tax simply because you are on a medical aid. Far fewer know about the second one, an extra credit for the years your medical bills ran high, and a surprising number of people never claim it. Here is how both work, in plain language, and how to check what you are actually owed.

The two medical aid tax credits, explained

There are two credits, not one, and they behave differently. The first is the medical scheme fees tax credit, which almost everyone calls the medical aid tax credit. It is a set rand amount for each person on your scheme, and you get it automatically, whatever plan you are on and whatever you pay. The second is the additional medical expenses tax credit. This one is not automatic, it depends on your age, your health and how much you spent, and it is the one people forget to claim when they file.

Both are credits, which means they come straight off the tax you owe, rand for rand. That makes them more valuable than a deduction, which only reduces the income your tax is worked out on.

How much is the medical aid tax credit in 2026?

The medical scheme fees tax credit is a fixed monthly amount per member, set by SARS and updated each year in the February Budget. It does not care which plan you chose or how big your contribution is, only how many people are covered on the scheme.

So a couple with two children gets R1,220 a month off their tax in the 2026 year, which is R14,640 across the year. If you earn a salary, this is usually already built into the PAYE your employer deducts each month, so you receive it as you go rather than as a lump sum when you file. The 2026 tax year runs from 1 March 2025 to 28 February 2026, and the 2027 year from 1 March 2026, which is the one to use when you plan ahead.

Work out your own credit in a few seconds

Enter how many people are on your scheme, add any big medical bills, and see both credits for your situation.

Open the Medical Tax Credit Calculator →

The extra credit almost nobody claims

The second credit, the additional medical expenses tax credit, is where money gets left behind. It gives back part of your heavier medical costs, and SARS splits taxpayers into two groups, with very different rules.

If you, your spouse or your child is 65 or older, or has a disability

This group is treated generously. You get back a third of your qualifying medical costs, and there is no income hurdle to clear first. Those costs are the part of your scheme contributions that runs above three times your annual medical aid tax credit, plus everything you paid out of your own pocket that the scheme did not cover. For a pensioner with a chronic condition, this can add up to a meaningful amount every year.

If you are under 65 with no disability

The bar is much higher. Only the part of your medical costs that passes 7.5% of your taxable income counts, and you get a quarter of whatever is left after that. On a taxable income of R400,000, that threshold is R30,000, so unless your excess contributions and out-of-pocket bills together beat it, this second credit comes out at zero. That is by design, and it is why a young, healthy taxpayer often sees nothing here. But a rough year, a hospital stay, a long run of dentist visits, glasses, or ongoing therapy, can tip you over the line, so it is always worth checking rather than assuming.

One thing to be careful about, out-of-pocket costs mean the shortfall you actually paid yourself, not the amounts your scheme reimbursed. Counting money the scheme already covered is the most common mistake, and it will not survive a SARS query.

A credit, not a refund

This catches people out, so it is worth saying plainly. A medical tax credit can only reduce tax you actually owe, it is never paid out to you as cash on its own. If your income is low enough that the normal rebates already bring your tax to zero, a pensioner on a small income for instance, there is nothing left for the medical credit to reduce, and it simply falls away. So the credit is real, but you only ever feel it as lower tax, whether through smaller monthly PAYE or a smaller bill when you are assessed.

How to claim it

The basic medical aid tax credit needs no effort if you are on a payroll, it is already in your monthly PAYE, and it is filled in on your tax return from your scheme's certificate. The additional credit is the one you have to claim, on your annual ITR12 return. To back it up, keep two things, the tax certificate your medical scheme sends you each year, which shows your contributions, and the receipts for anything you paid yourself and were not refunded for. SARS can ask for proof, so hold on to them.

Check what you are owed

The numbers are simple enough once you know the rules, but the second credit in particular is easy to get wrong by hand. Our free medical tax credit calculator does both for you, for the 2026 or 2027 tax year, and warns you when a credit is bigger than the tax you actually pay. If the credit still leaves your cover feeling expensive, it may be worth checking whether your plan is the right one, our medical aid plan comparison ranks plans against your household without a broker, and the PMB and chronic condition checker shows exactly what your scheme must pay for by law.

Open the Medical Tax Credit Calculator →

This is general information based on the SARS medical tax credit and income tax tables for the 2026 and 2027 tax years, not tax advice. Your own position can differ, so confirm the details with SARS or a tax practitioner. Last reviewed July 2026.