Demand-ranked tax questions · Individual · Question 18 of 20

How do medical tax credits work in South Africa?

A medical scheme fees tax credit reduces normal tax; it is not a deduction from income or a cash refund by itself. For 2026/27, the monthly credit is R376 for each of the first two covered persons and R254 for each additional dependant. A separate additional medical expenses credit may apply to qualifying unrecovered costs.

Last reviewed: 28 August 2026

The points that decide the answer

The fixed monthly credit depends on covered persons and months, not the premium amount alone.
Additional medical expenses use different calculations for taxpayers aged 65 or older, persons with a disability, and other taxpayers.
For other taxpayers, the formula includes a 7.5% taxable-income threshold.
Only qualifying expenses actually paid and not recovered can enter the calculation.

A practical way to handle it

Reconcile the medical scheme tax certificate.
List qualifying out-of-pocket expenses and remove refunds.
Confirm dependant and disability status where relevant.
Compare the final ITR12 calculation with supporting schedules.

Common mistakes

Claiming statements rather than amounts paid
Including cosmetic or non-qualifying costs
Duplicating expenses shown by the scheme

What to keep on file

Medical scheme certificate, invoices, receipts, proof of payment, claims statements and disability confirmation.

Source and scope

Based on current SARS guidance, reviewed on 28 August 2026. This is general information, not tax advice. Rates, thresholds and outcomes depend on the tax year and your facts. Regulated submissions and advice are handled through registered partners where required.