Medical Expenses Tax Claim: Get Every Rand Back in 2026

Last Updated: September 2026 | Reading Time: 7 minutes

South Africa gives you two medical tax credits – one for belonging to a medical scheme and one for out-of-pocket expenses. Most taxpayers claim the first and forget the second.

Stethoscope on medical aid certificate with South African rand notes

Quick Answer

You can claim two medical credits in 2026: the Medical Scheme Fees Tax Credit (R376 per month for the main member and first dependant, R254 for each additional dependant) and the Additional Medical Expenses Tax Credit (25% of qualifying out-of-pocket expenses plus scheme contributions above 4x the MTC, for under-65s without disability). Both come straight off your tax bill.

Credit 1: Medical Scheme Fees Tax Credit (MTC)

If you contribute to a registered medical scheme, SARS gives you a fixed monthly credit against your tax:

Member	Monthly credit 2026
Main member	R376
First dependant	R376
Each additional dependant	R254

A family of four therefore saves R15,312 in tax over the year. This credit applies automatically when your medical aid certificate is captured – check it on your ITA34.

Credit 2: Additional Medical Expenses Tax Credit (AMTC)

This is the one people miss. If you are under 65 with no disability in the household:

AMTC = 25% x [(scheme contributions – 4 x MTC) + qualifying out-of-pocket expenses]

Qualifying out-of-pocket expenses include amounts your scheme did not cover: prescribed medication, specialist co-payments, dental and optometry costs, physiotherapy and similar. Over-the-counter vitamins and cosmetic procedures do not qualify.

If you, your spouse or a child has a disability (as defined on the SARS ITR-DD form), or you are 65 or older, the formula is far more generous – 33.3% of qualifying expenses with no threshold. An ITR-DD confirmation from a registered practitioner must be on file.

Documents You Need

Medical scheme tax certificate – issued by your scheme around May, showing contributions and claims not refunded
Pharmacy and practitioner invoices/receipts for out-of-pocket amounts
ITR-DD disability confirmation, where applicable

Add these to your tax return checklist pack. Keep everything five years – medical claims are a favourite verification target, so be ready for the SARS verification process.

Worked Example

Scenario: The Naidoo family (2 adults, 1 child) paid R5,800/month to their scheme and R22,000 out-of-pocket in the 2026 tax year.

MTC: (R376 + R376 + R254) x 12 = R12,072
Contributions: R69,600. 4 x MTC = R48,288. Excess: R21,312
AMTC: 25% x (R21,312 + R22,000) = R10,828
Total medical credits: R22,900 off their tax bill

Important: this is not a free service. TaxSeason2026.online is the website of Admin Boss – Tax division, a private South African tax practice that assists individuals with the preparation and filing of their SARS tax returns for a professional fee. We are not SARS and we are not affiliated with SARS or any government body. SARS eFiling itself is a free government channel – our fee covers expert review, deduction optimisation and done-for-you filing.

Frequently Asked Questions

Can I claim medical expenses if I am not on a medical aid?

Yes – qualifying out-of-pocket medical expenses may still generate an Additional Medical Expenses Tax Credit for taxpayers 65 and older or where a disability applies. For under-65s without disability, out-of-pocket expenses alone generally produce no credit unless you also have scheme contributions – the formula requires contributions above 4x the MTC.

What medical expenses does SARS not allow?

Non-prescribed over-the-counter medicines, vitamins and supplements, cosmetic surgery, gym contracts and medical insurance (gap cover) premiums do not qualify. Only amounts paid to registered medical practitioners and schemes count.

My employer pays my medical aid – can I still claim?

If the employer contribution appears as a fringe benefit on your IRP5 (code 3810), you are treated as having paid it and you claim the credits. If the company pays the scheme directly outside payroll, you cannot claim.

Need Help?

Admin Boss – Tax division prepares and files personal income tax returns for clients across South Africa – 100% remote, no office visit needed. Contact us for a quote or call 074 918 7130 (Mon-Fri 08:00-16:00).

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