Medical tax credit rates 2026/27 at a glance
A medical credit reduces tax, rather than your taxable income. Section 6A gives a monthly credit for eligible medical scheme contributions. Section 6B can give an additional credit for qualifying expenses and excess scheme fees. Use the medical credits calculator to estimate both.
| Person covered | 2026/27 | 2025/26 |
|---|---|---|
| First person | R376 | R364 |
| Second person | R376 | R364 |
| Each additional person | R254 | R246 |
These current rates apply from 1 March 2026 to 28 February 2027. The 2026 filing season normally deals with the earlier 2025/26 year. For that return use the comparison column and select 2025/26 in the calculator. The year on your tax certificate is a better guide than the date you downloaded it.
The SARS rates table names each assessment year by its ending year: its 2027 column means 2026/27. Checking that distinction prevents a common mismatch between a scheme certificate and an online estimate.
Section 6A: the medical scheme fees tax credit
The credit depends on qualifying people and months for which contributions were paid to a registered scheme or qualifying similar foreign fund. It is a fixed amount, not a percentage of the premium. Paying for a more expensive plan does not increase the monthly section 6A rate.
For two covered people for a full year, the monthly credit is R752, giving R9,024 over twelve months. The first two rates are equal; a third person adds the lower additional-person rate. Use the certificate's member history if someone joined, left or changed status during the year.
For one person covered for six eligible months, this engine example gives R2,256: six times R376. Do not multiply by twelve merely because a certificate was issued for an annual period. Where member counts change across months, use the actual monthly history; a single uniform member count cannot fully describe that pattern. Add only the per-period section 6A credits; calculate section 6B once on annual totals using the combined annual section 6A credit. The refund estimator excludes shared contributions: where taxpayers share fees, SARS requires section 6A to be apportioned by each payer’s share of total contributions.
Read SARS's medical credit explanation for the payment and dependant requirements. Medical insurance that is not a qualifying medical scheme does not automatically create a scheme fees credit.
Section 6B: additional medical expenses tax credit
First separate your scheme fees from qualifying expenses paid outside the scheme. Reimbursements cannot be counted again. A credit may be zero even when you paid substantial bills; the calculation depends on your age, disability circumstances, income and annual scheme credit.
| Category | Calculation |
|---|---|
| Under 65, no qualifying disability | 25% × max(0, max(0, annual fees − 4 × MTC) + qualifying expenses − 7.5% × taxable income) |
| 65+, or taxpayer/spouse/child with qualifying disability | 33.3% × (max(0, annual fees − 3 × MTC) + qualifying expenses) |
The excess-fees part cannot be negative. For an older person paying R12,000 annual fees with R10,000 qualifying expenses, the fees are below three times the annual credit of R4,512. The additional credit is therefore R3,330, based on the expenses; low fees do not cancel those expenses.
Under 65, add the non-negative excess fees to the expenses before applying the income threshold. Do not test expenses alone against the threshold and then add an unrestricted credit for excess premiums. See the SARS AMTC calculation for the statutory categories and exclusions from the relevant taxable-income figure.
A qualifying disability must relate to you, your spouse or your child for the enhanced formula. A physical impairment is not automatically the same as a defined disability, and a disabled parent does not activate that category for a younger taxpayer. The prescribed expenses and medical certification requirements still matter.
Worked examples: the same figures as the refund calculator
Both examples below use 2026/27, age 35, annual taxable income of R400,000 and PAYE of R60,000. Before medical credits, income tax after the primary rebate is R67,417. They illustrate a complete year with no retirement or donation deduction.
Two covered people: the scheme credit only
T3: twelve months of cover, annual scheme fees R36,000 and no qualifying out-of-pocket expenses.
- Monthly scheme credit × 12
- R752 × 12 = R9,024
- Four times the scheme credit
- R36,096
- Additional credit (no excess fees or expenses)
- R0
- Annual tax after medical credits
- R58,393
One covered person with qualifying expenses
T4: twelve months of cover, annual scheme fees R48,000 and qualifying out-of-pocket expenses R10,000.
- Annual scheme credit
- R4,512
- Fees above four times the credit
- R29,952
- Income threshold: 7.5% × R400,000
- R30,000
- Additional credit from the combined excess
- R2,488
- Annual tax after medical credits
- R60,417
A medical credit can help without turning an amount owed into a refund. To see the full calculation alongside PAYE, retirement and other income, use the refund estimator. Use your actual annual contribution total rather than guessing from a recent debit order.
Who can claim: payments for dependants and spouses
Follow the payment evidence and SARS's dependant definitions. If you pay a qualifying dependant's contributions while not being a scheme member yourself, the first-person credit can still be relevant. Do not assume that the policy's main member is necessarily the person entitled to claim.
When spouses both contribute, do not each claim the same full certificate amount. Contributions and entitlement may need allocation between taxpayers. The ITR12 guide's medical section covers family-member payments and the information needed. Match your claim to who paid and keep proof if the certificate alone does not show it.
Dependants for medical tax purposes include more than minor children, but the precise definition matters. A family relationship, a shared home or a name on a receipt is not by itself enough to answer every case. Check the definition before adding another person to the calculation.
Which expenses qualify?
SARS's qualifying expenses list covers eligible registered practitioner services, hospitalisation, registered nursing, prescribed medicines and substantially similar foreign services. Prescribed impairment or disability expenditure has additional conditions. The costs must have been paid and not recoverable.
Keep a record of the patient, provider, service date, amount, payment and any scheme reimbursement. If you submitted a claim and the scheme later paid it, remove that recovered amount from your out-of-pocket total. A rejected claim is not automatically tax eligible: it still has to meet SARS's rules.
For disability-related claims, consult the prescribed expenditure list and retain the required ITR-DD confirmation. A broad description such as “health spending” is not enough. Do not add general wellness purchases just because they support your health; work through the specific qualifying categories.
How to claim on your ITR12
- Choose the correct assessment year and obtain the scheme tax certificate for that period.
- Check the prefilled scheme details, contribution total and monthly member counts against the certificate.
- Complete the relevant medical and qualifying expense sections, including contributions paid for eligible family members where applicable.
- Enter expenses you paid and were not reimbursed for; avoid duplicating amounts shown in another section.
- Complete the disability questions only where the defined requirements are met and retain the certification.
- Review the calculation, submit the return and respond to any request for supporting documents.
Missing information may require correction even if SARS auto-assessed you. The filing hub explains what to do when an assessment is incomplete. A calculator result helps you check the logic; it does not replace the return or supporting evidence.
Common mistakes to avoid
- Using the current rate for an earlier assessment year.
- Claiming twelve months when cover started partway through the year.
- Counting expenses the scheme reimbursed, or treating an insurance premium as a registered scheme contribution.
- Claiming the same payment on both spouses' returns.
- Activating the enhanced disability formula for a dependant other than a qualifying spouse or child.
- Expecting unused credits to be paid out or carried to a later year.
Read the deductions guide to distinguish medical credits from retirement deductions. The income tax calculator explains normal tax, while our medical aid section explains schemes and cover.
Calculate your medical credits
Use the medical credits calculator with your average monthly fees for the covered months, actual contribution months, covered members and qualifying expenses. Divide the annual scheme certificate total by the number of contribution months you enter. Select the correct tax year and enter age at year end. If member counts changed during the year, check the monthly allocation separately before filing.
Official sources
Frequently Asked Questions
R376 a month for the first covered person, R376 for the second and R254 for each additional person. Only eligible contribution months count. Filing season 2026 normally assesses 2025/26, which uses that earlier year’s rates.
The medical scheme fees and additional medical expenses credits are non-refundable rebates. They reduce normal tax to a minimum of zero; unused credits cannot carry forward. A PAYE refund can still arise if tax already paid exceeds the reduced annual liability.
The claim follows who paid the qualifying contributions and the SARS dependant rules. Being the scheme member alone does not establish that you paid. If your parent pays, check their entitlement rather than claiming the same payment yourself. The SARS medical guide covers contributions for family members.
Only qualifying amounts paid and not recoverable, including eligible registered practitioner, hospital, nursing and prescribed medicine costs, plus prescribed impairment or disability expenditure. Keep receipts and proof of payment. Do not include amounts reimbursed by the scheme.
For taxpayers under 65 without a qualifying disability, combine qualifying expenses with scheme fees above four times the scheme credit. Only the amount above 7.5% of relevant taxable income attracts the 25% additional credit. Excess scheme fees are floored at zero before combining the amounts.
People aged 65 or older use the 33.3% additional credit formula, without the 7.5% income threshold. The same formula applies where the taxpayer, spouse or child has a SARS-defined disability. A disabled parent alone does not activate this formula for a younger taxpayer.