Medical Tax Credit Calculator (South Africa)

South Africa's medical tax credit system, introduced in 2012 to replace the previous medical expense deduction, operates in two tiers under sections 6A and 6B of the Income Tax Act. The Section 6A credit is a fixed monthly rand-value credit — R364 per month for each of the first two medical aid members and R246 for each additional dependant for the 2024/25 tax year — which reduces your income tax liability directly rather than reducing taxable income. This makes it equally valuable to all taxpayers regardless of their marginal tax rate. The credit is applied automatically through your employer's PAYE deductions if you have supplied your medical aid details, and appears as a credit on your final ITR12 assessment when you file with SARS each year.

The Section 6B additional medical expenses credit provides further relief for taxpayers whose medical costs are unusually high. For individuals under 65, only qualifying expenses that exceed four times the annual Section 6A credit attract the 25% credit — effectively meaning the credit acts as a top-up once your contributions and out-of-pocket costs breach a meaningful threshold. Taxpayers aged 65 and above benefit from the 33.3% rate applied to all qualifying costs without any floor, reflecting the higher medical burden in retirement. Out-of-pocket expenses that may qualify include co-payments, specialist fees not covered by your scheme, prescribed medication, and approved therapeutic devices. Keep meticulous records and obtain an annual medical tax certificate from your scheme, as SARS increasingly cross-references declared amounts against third-party data submissions during automated assessments.