1. The Short Answer

South Africa does not let you deduct medical aid contributions from your income. Instead, SARS gives you two tax credits, which come straight off the tax you owe:

Most salaried people already get the MTC every month through PAYE. The AMTC is only worked out when you file your annual return, which is why it can turn a small refund into a bigger one.

2. The Monthly Medical Scheme Fees Credit

The MTC is a fixed rand amount per month, no matter how expensive your medical aid plan is. SARS raised it in Budget 2026 for the first time in two years.

Person covered2025/2026 (per month)2026/2027 (per month)
Main memberR364R376
First dependantR364R376
Each additional dependantR246R254

A family of four (two adults, two children) on medical aid for the whole 2026/2027 tax year gets R376 + R376 + R254 + R254 = R1,260 a month, or R15,120 for the year, off their tax.

Rules worth knowing

3. The Additional Medical Expenses Credit

The AMTC has three versions. Find the one that applies to you; it is decided by the oldest and most vulnerable person in the calculation, not by the person who earns the most.

You are 65 or older

You get 33.3% of:

There is no income test. Every rand of qualifying out-of-pocket cost earns a credit.

You are under 65 and you, your spouse or your child has a disability

The same formula as for over-65s: 33.3% of contributions above three times the MTC, plus 33.3% of qualifying expenses. The disability must be confirmed by a medical practitioner on the SARS ITR-DD form. This version is only available when the person with the disability is you, your spouse or your child; another dependant with a disability does not qualify for it.

Everyone else (under 65, no disability)

This is the version most people fall under, and it is much harder to qualify for. You get 25% of the amount by which these two items together:

exceed 7.5% of your taxable income. Taxable income here excludes retirement fund lump sums and severance benefits.

What the 7.5% rule means in practice: someone with a taxable income of R400,000 needs more than R30,000 a year of "excess" contributions and out-of-pocket costs before the credit starts. That is why most healthy people under 65 get no AMTC at all, but a family with a big hospital co-payment or an expensive chronic condition often does.

4. Which Out-of-Pocket Expenses Qualify

"Qualifying medical expenses" are costs you paid yourself and that your medical aid did not pay back. The common ones are:

These do not qualify:

Payments from your medical savings account are a common trap: the savings money came from your contributions, which already count once in the formula, so you cannot count the claim again as an out-of-pocket expense.

5. Worked Examples

Example A: couple under 65, large out-of-pocket costs

Nomsa is 42 and has a taxable income of R400,000. She pays R60,000 a year in medical aid contributions for herself and her husband. This year she also paid R25,000 in qualifying costs the scheme did not cover, mostly a specialist shortfall.

Her total medical credits are R13,750. Without the specialist bill, the formula would have come to less than R30,000 and her AMTC would have been zero.

Example B: pensioner, 65 or older

Johan is 70, a single member of a medical aid, and pays R48,000 a year in contributions. He spent R20,000 on prescribed medicine and specialist shortfalls.

No income test applies, so Johan gets this regardless of his pension income, up to the amount of tax he owes. Together with his age rebates, this often reduces a pensioner's tax to zero, and is a common reason pensioners are owed a refund.

6. When Your Employer Pays the Medical Aid

Many employers pay part or all of the medical aid contribution. Their share is a taxable fringe benefit: it is added to your salary for tax purposes and shown on your IRP5. In return, SARS treats you as having paid it, so you still get the full MTC and the contribution counts in the AMTC formula.

On your IRP5 you will usually see the employer's contribution as a fringe benefit (code 3810), total medical aid contributions (code 4005), and the MTC your employer already gave you through PAYE (code 4116). Our payslip and IRP5 guide explains these codes.

7. How to Claim on Your Return

  1. Get your medical aid tax certificate. Your scheme issues one after the tax year ends (the year runs 1 March to 28 February). It lists contributions paid and any out-of-pocket amounts the scheme knows about.
  2. Collect receipts for costs the scheme does not know about, such as prescribed medicine you paid for at the pharmacy without claiming.
  3. Complete the medical section of your ITR12 on eFiling. If SARS auto-assessed you, check whether the out-of-pocket costs were picked up. If not, file a corrected return before the deadline.
  4. If there is a disability, have a medical practitioner complete the ITR-DD and keep it; SARS can ask for it. A new ITR-DD is needed when the disability is not permanent.

Keep everything for five years. Medical claims are among the items SARS most often asks taxpayers to support with documents.

8. Common Mistakes

To see what the monthly credit does to your take-home pay, use our PAYE calculator and select the number of people on your medical aid.

See Your Medical Credit on Your Payslip

Pick the number of people on your medical aid and see your 2026/2027 take-home pay.

Open PAYE Calculator →

Frequently Asked Questions

How much is the medical tax credit in South Africa for 2026/2027?

R376 a month for the main member, R376 for the first dependant and R254 for each additional dependant. A family of four gets R1,260 a month off their tax.

Can I claim medical expenses on my tax return if I am under 65?

Yes, but only the part that exceeds 7.5% of your taxable income after adding medical aid contributions above four times your annual medical credit. You then get 25% of the excess as a credit.

Do pensioners get more medical tax relief?

Yes. From age 65 there is no 7.5% income test: you get 33.3% of contributions above three times your annual credit plus 33.3% of all qualifying out-of-pocket medical costs.

Is over-the-counter medicine tax deductible?

No. Only medicine prescribed by a registered practitioner and bought from a pharmacist counts as a qualifying medical expense.

Do I get the medical tax credit if my employer pays my medical aid?

Yes. The employer's contribution is a taxable fringe benefit, and SARS treats you as having paid it, so you get the full credit.

Sources

Every figure on this page was checked against these official sources on 1 November 2026:

Disclaimer: This guide is general information, not tax advice. The author is not a registered tax practitioner. Tax rules change with each Budget; for advice on your own situation, speak to a SARS-registered tax practitioner.