Medical Aid Tax Credits in SA

SARS allows two types of medical tax relief: the Medical Scheme Fees Tax Credit (MTC) - a fixed monthly rebate - and the Additional Medical Expenses Tax Credit (AMTC) for out-of-pocket and excess scheme costs. Together they can return R5,000 - R28,000+ per year to South African taxpayers.

2025/26 Medical Scheme Fees Tax Credit (MTC)

Beneficiary | Monthly credit | Annual
Main member | R364 | R4,368
First dependant | R364 | R4,368
Each additional dependant | R246 | R2,952

A family of four therefore receives R364 + R364 + R246 + R246 = R1,220/month or R14,640/year as a direct reduction of tax owed (not deduction from income).

Additional Medical Expenses Tax Credit (AMTC)

The AMTC covers qualifying medical spend not paid by your scheme - savings depleted, threshold exceeded, gap cover not claimed.

If you are under 65 and not disabled

Formula: 25% x (qualifying expenses - 7.5% of taxable income) + 25% x excess MTC. Effectively, only large out-of-pocket spend (above 7.5% of income) qualifies.

If you are 65+ or have a disabled dependant

Formula: 33.3% x (medical scheme contributions - 3x MTC) + 33.3% x qualifying expenses. Far more generous.

What qualifies as "qualifying medical expenses"

GP and specialist consultations (paid out of pocket or savings)

Prescribed medication (must have a script)

Hospital co-payments

Dentistry, optometry, physiotherapy, audiology

Approved disability-related expenses (with ITR-DD form completed by a doctor)

Travel for medical treatment (with kilometre log)

Documentation SARS expects

Annual Tax Certificate from your medical scheme (issued every July).

Itemised receipts for every out-of-pocket expense.

ITR-DD form for disability claims (renew every 5-10 years depending on disability type).

SARS verification can request 5 years of records - keep receipts and statements scanned.

Common errors that trigger SARS audits

Claiming non-prescribed over-the-counter medicines, including expenses already reimbursed by gap cover, double-counting savings withdrawals, claiming dependants who exceed the income threshold (currently R83,100 for 2026), and forgetting to subtract employer contributions when applicable.