Medical Aid Tax Credits: How to Maximise Your Rebate

Of all the deductions available to South African taxpayers, the Medical Scheme Fees Tax Credit is one of the most valuable — and one of the least understood, because unlike most deductions it doesn't reduce your taxable income. It reduces the actual tax you owe, rand for rand.

How the credit is structured (2025/2026 tax year)

The credit is a fixed monthly amount per person on your medical scheme, not a percentage of what you pay:

• R364/month for you as the main member
• R364/month for your first dependant
• R246/month for each additional dependant after that

So a family of four (you, your spouse, and two children) gets: R364 + R364 + R246 + R246 = R1,220 per month, or R14,640 for the year — taken directly off your tax bill, regardless of your income bracket.

The additional credit (Section 6B)

If your medical scheme contributions plus your own out-of-pocket medical expenses (things your scheme didn't reimburse) exceed a threshold linked to your income, you can claim an additional medical expenses tax credit on top of the main credit. The calculation differs depending on whether you (or a dependant) have a SARS-recognised disability — the threshold is more generous in that case. This is exactly the kind of calculation that's easy to get wrong by hand, since it depends on your taxable income, your age, and how much you've already paid through the main credit.

What counts as "additional medical expenses"

Only amounts not recovered from your medical scheme count — think of things like a portion of a hospital co-payment, out-of-network specialist fees, or prescribed medication not covered by your plan. Keep every receipt; SARS wants amounts that tie back to your scheme's own statement showing what was and wasn't paid out.

The most common mistake

People assume their medical aid contribution is a normal deduction that reduces taxable income like a retirement annuity does. It isn't — it's a credit against tax payable, applied after your tax liability is calculated from your bracket. This actually works in your favour if you're in a lower tax bracket, since a rand-for-rand credit is worth the same to every taxpayer regardless of their marginal rate, unlike a deduction which is worth more to people in higher brackets.

When you upload your medical aid tax certificate, Tax Chommie automatically applies both the main credit and checks whether you qualify for the additional credit based on your other uploaded documents — no manual threshold math required.