Medical Expenses & Tax
Medical Expenses & Tax
Private medical treatment is increasingly pushing the limits of medical aid scheme benefits and our own wallets. However, it's an outlay that few of us can avoid. Luckily, certain medical expenses may come with a bit of tax relief in the way of tax credits.
A tax credit is a deduction off your tax payable. This means that your contributions to a medical aid, as well as a portion of your 'qualifying expenses' (certain medical related spend), is converted to a tax credit, which is deducted from your overall tax liability (the amount of tax you have to pay SARS). You can't carry any unused credit over to the next tax year and it won't ever result in a standalone refund from SARS. This means that if you don't earn an income, but do contribute to a medical aid, you can't claim the medical credit. SARS does not give money back unless tax has been paid already.
Many people are unsure of what medical expenses are allowed, and even more unaware of the medical aid tax credit calculations used.
Let's sort that out, shall we?
Before we get into the actual numbers, it's likely that you're not only paying for your own medical expenses but probably for those of your immediate and sometimes extended family too. For this reason, it's important to understand what SARS considers as 'dependents'.
Who SARS Considers as Dependents for Medical Expense Claims
Here's a handy list of who SARS considers dependents:
- A spouse (husband, wife or same sex partner)
- A child and the child of a spouse (e.g. son, daughter, stepchild or children, adopted child or children) who was alive during any part of the year of assessment, and provided that on the last day of the year of assessment he / she was unmarried and:
- a minor, i.e. under the age of 18, or
- under 21 years of age, but partly or entirely dependent on you for maintenance and not yet liable for normal tax themselves, or
- under 26 years of age, but partly or entirely dependent on you for maintenance, not yet liable to pay normal tax themselves and a full-time student at a publicly recognised educational institution like a university or technikon
- Any other member of your family who relies on you for family care and support (e.g. mother, father, sibling, mother or father-in-law, grandparent or grandchildren)
- Any other person recognised as a dependent in terms of the rules of a medical scheme or fund
Medical tax credits
Medical Aid Contributions
SARS calls this rebate the 'Medical Schemes Fees Tax Credit' and it applies to the fees paid by a taxpayer to a registered medical scheme for you (as the taxpayer) and your dependent/s. The credit for 2027 is a fixed monthly amount of R376 (2026: R364) for you as the primary member, a further R376 for your first dependent and R254 (2026: R246) for each of your additional dependents.
John's monthly medical tax credit 2026 tax year
John pays for medical aid for himself, his wife and his three children.
John's tax liability is therefore decreased by R1,466 per month. Note that this is a flat rate per month and doesn't take his taxable income into consideration.
If you're paying your contributions via your employer (as a deduction from your salary or wages), your employer is obliged to use the credit system to reduce your monthly PAYE tax. If you pay medical aid independently of your employer however, your monthly PAYE won't be adjusted, and you'll therefore end up overpaying tax (which you'll be able to claim back as a refund when you submit your annual tax return).
Additional Medical Expenses Tax Credit
The Additional Medical Expenses Tax Credit is in place to provide some credit for excess medical expenses and is made up of two parts:
- Excess medical aid contributions, and
- Qualifying medical expenses / Out-of-pocket medical costs (i.e. those not reimbursed or claimed from medical aid), which you pay for yourself.
Excess medical aid contributions are relatively straightforward to work out, as you'll use the total amount you paid towards medical aid as your first amount and then apply the formula applicable to your individual situation. We'll get to this in a moment.
Out-of-pocket expenses are a bit more complex. Out-of-pocket medical costs, as per SARS, are those qualifying medical expenses that you've paid for yourself, which have not been reimbursed by medical aid. If you submit ALL your medical expenses to your medical aid, this amount is normally reflected on your tax certificate from the Medical Aid as 'claims not paid', 'amount not reimbursed' or something similar. Remember that this won't include expenses you paid for but didn't submit to medical aid you'll have to add those up separately. This doesn't mean that you can include all and sundry from the pharmacy though! SARS has certain restrictions on what qualifies as an out-of-pocket medical expense.
What are Qualifying Medical Expenses for Tax?
Examples of qualifying medical expenses are any amounts that were paid by you, as the taxpayer, during the year of assessment:
- For professional services rendered and medicines supplied by a registered medical practitioner, dentist, optometrist, homeopath, naturopath, osteopath, herbalist, physiotherapist, chiropractor or orthopaedist to you or any of your dependant(s)
- To a nursing home or hospital, or any duly registered or enrolled nurse, midwife or nursing assistant (or to any nursing agency for the services of a nurse, midwife or nursing assistant) in respect of the illness or confinement of the person or any dependant of the person
- For medicines prescribed by a registered medical practitioner and acquired from a pharmacist
- Medical expenses incurred and paid outside South Africa
It's important to note that "over the counter" medicines like cough syrups, headache tablets or vitamins don't qualify as medical expenses that are taken into account for tax purposes, unless they're specifically prescribed by a registered medical practitioner and acquired from a pharmacist. Now that we know what qualifies as medical expenses you can claim back, let's look at how you work out your additional medical expenses tax credit.
How to calculate your Medical Tax Credit
The formula you need to use depends on two factors:
- Your age whether you're older or younger than 65, and
- If you or your dependent(s) have a disability.
SARS is strict on the definition of a qualifying disability. According to the Income Tax Act, a disability is:
A moderate to severe limitation of that person's ability to function or perform daily activities, as a result of a physical, sensory, communication, intellectual or mental impairment if the limitation has lasted or has a prognosis of lasting more than a year, and is diagnosed by a duly registered medical practitioner in accordance with the criteria prescribed by the Commissioner.
In order to benefit from the full disability-related medical expenses provisions, you'll need to have an ITR-DD form (confirmation of diagnosis of disability form for an individual taxpayer) completed by a registered medical practitioner within the last five years.
| Age and Disability Status | Formula used to calculate additional Medical Expenses Tax Credit |
|---|---|
| Under 65, No Disability |
25% of:
|
| Under 65, Disability |
33.3% of:
|
| 65 or Over, With or Without Disability |
33.3% of:
|
Let's look at a worked example including the Medical Scheme Fees Credit to show the different steps in the calculation.
Samson is 40 years old and pays R5,000 a month to a medical aid fund for himself, his wife and their two children. His youngest child had been quite ill throughout the year and by 28 February 2025, he'd paid R25,000 for medical treatments that had not been claimed back from his medical aid, as his savings had run out. Samson's taxable income for the year was R360,000.
All credit values and calculations above are based on the 2025/2026 tax year (1 March 2025 to 28 February 2026). If you're completing tax returns for other tax years, different amounts, limits and conditions may apply.
Follow the above formulas to calculate your medical aid tax credit, or use our handy Medical Aid Tax Credit Calculator which will do it all for you, in a matter of seconds.
Disability
As mentioned earlier, you're also allowed to take into account qualifying physical disability expenditure when computing your medical tax credit. This is over and above any qualifying contributions made to medical schemes and qualifying medical expenses incurred and paid.
A physical disability can be described as a condition or dysfunction, of a permanent nature, which requires the person who has the condition or dysfunction to use special equipment or receive medical treatment in order to perform general life functions. A temporary condition or illness that can be treated with, for example, medication or exercise, is not regarded as a physical disability. It's not a requirement that the condition result from physical injury.
The expense must be directly because of a physical disability suffered by you, your spouse, your or your spouse's children, or any of your dependants. Expenditure incurred in respect of a dependent will only qualify if:
- you were a member of a registered medical scheme; and
- at the time the expense was paid, the person was admitted as a dependant of yours in terms of the rules of the medical scheme.
Taxpayers must ensure that the following information is available:
- Full details of the nature of the physical disability.
- Evidence that the expense was incurred "in consequence of" the physical disability, that is, directly connected with the physical disability and/or incurred as a necessary result of it.
- Why was it necessary to incur the expense? Was the expense inevitable, or unavoidable, in such a way that it cannot be otherwise, of necessity?
- Completed ITR-DD Confirmation of Diagnosis of Disability form
- Proof of payment for treatments, prescriptions etc.
Medical aid source codes
Below is a list of the main medical source codes, together with a description, that you'll see on your tax return:
Supporting Documents for medical expense claims
Supporting documents are required to complete the medical aid section of the tax return. Below we discuss in detail the list of documents and information that may be required for you to claim back your medical expenses.
Medical Schemes Fee Credit
If you contribute to a medical aid, you'll need to submit your medical aid tax certificate to SARS in order to claim your fixed monthly credit. You'll find more details on how to get this certificate in the next section.
Out of Pocket Medical Aid Expenses
If you paid for medical expenses personally (i.e. these were not reimbursed by the medical aid) you will need to provide supporting invoices and receipts to SARS. Such as doctors bills, specialist bills, prescription medication and hospital bills.
Disability expenses
Besides the duly completed ITRDD, you will also need to provide all supporting invoices and receipts to SARS.
Where can I get my Medical Scheme Tax Certificate?
This certificate details exactly how much was paid to the medical aid for yourself and your dependents over the course of the tax year (1 March to 28/29 Feb). It also details how much money you paid for other medical expenses, such as medicines and doctors' expenses, which you claimed for, but your medical aid did NOT cover. This information is important for your tax return and the information included can improve your chances of getting a tax refund when you submit.
Your medical scheme provider is supposed to send your tax certificate to you by email or post by July, but if they haven't done it yet, you can ask for it directly. Most medical aid providers offer a self-service portal online where you can login and download your tax certificate. Others have a call centre that you can phone and ask that they post or email your tax certificate to you.
Select your medical aid / medical scheme below to get your tax certificate:
FAQ
No GAP cover is treated as short term insurance and not medical cover, which means it's not claimable for tax purposes and therefore you can't include it as part of your qualifying medical expenses.
Yes, you can in the opening questions of your Tax Return, you need to answer "yes" to the question asking if you pay medical expenses (including medical aid where you are not the main member) in respect of a dependent. The medical section of the return will then open up a section which will allow you to enter these medical aid details and/or medical expenses you pay on behalf of your parents. For medical aid payments, you would only be able to claim this credit if you directly paid the medical aid from your bank account. If SARS does request proof, you need to supply them with a Medical Aid contribution certificate from the medical provider / scheme, along with proof of payments as well as a letter indicating why you're making payment for someone else and whether they're financially dependent on you. If applicable, you'll also need to supply medical invoices and receipts.
Since your wife is the main member of the medical aid, it would be simpler for her to claim the medical credit in her tax return. However, if you're willing to gather all the paperwork for SARS, it should be possible for you to claim the medical credit yourself, instead of your wife. In the opening questions of your Tax Return, you need to answer "yes" to the question asking if you pay medical expenses (including medical aid where you're not the main member) in respect of a dependent. The medical section of the return will then open up a section which will allow you to enter these medical aid details. If SARS does request proof, you need to supply them with the Medical Aid contributions certificate from the medical provider / scheme, along with proof of payment, as well as a letter indicating why you're making payment where you're not the main member and whether your wife is financially dependent on you.
Your husband will need to claim the medical on his tax return as he is the main member of your medical aid. He will get the tax benefit for both of you which would be the same as if you made the claim. Unfortunately, SARS won't split the benefit and pay out your share to you separately, so you will need to claim your portion of the tax credit back from your husband.
This is because your employer is obligated to adjust your monthly PAYE deductions by the medical tax credit and therefore you've already received your medical tax credit during the year (by way of reduced employee's tax on your salary).
This is because SARS uses a very complicated formula to calculate whether your out of pocket medical expenses will reduce your total tax owing. The calculation depends on the taxable income you earn and in many taxpayers' cases there actually is no additional medical credit this is because their qualifying (out of pocket) medical expenses are not high enough and therefore the required threshold is not met in order for an additional medical tax credit to kick in. Please use our handy medical calculator to see what your medical tax credit will be.
As long as the return was not filed more than three years ago, yes you can definitely lodge a dispute and attach a schedule of your medical expenses and the proof of payment of each expense, along with their invoices.
You should declare both medical aids on your tax return to ensure that you get a tax credit for your contributions to both medical aids. Please state on the first section of your medical section that you had more than one medical aid and then enter each medical aid separately.
Yes you can, but please ensure that this expense is paid in full, as SARS will need to see the invoices and the proof of payment.
No, you unfortunately can't claim a deduction for it as the expenses were not paid by you directly.
Unfortunately not, medical insurance is quite different to medical aid and not claimable.
Yes, a hospital plan offered by a registered medical aid company can be claimed for a medical tax credit, exactly the same as a traditional full medical aid.
No, you can't claim these. You need to have prescription medicines in order to make a claim for this kind of out of pocket expenditure.
If you claim out of pocket medical expenses you should remember to send SARS each invoice and the proof of payment for it (either an EFT slip or the normal cash slip, depending on how you paid the expense) and a schedule showing the date the expense was incurred, date amount was paid, how it was paid and if it was paid in full at the same time or if you paid it off in instalments.