In South Africa, you cannot claim your health insurance premiums back on tax, because SARS medical tax credits apply only to contributions paid to a registered medical scheme (medical aid), not to health insurance. However, you may still be able to claim a portion of your qualifying out-of-pocket medical expenses through the Additional Medical Expenses Tax Credit, whether or not you belong to a scheme. If you are on a medical aid, you also receive the Medical Schemes Fees Tax Credit. This guide explains how both credits work.
When tax season comes around, a common question is whether you can claim money back for your healthcare costs. The answer depends on what kind of cover you have and what you paid out of your own pocket. Since 2012, South Africa no longer lets you deduct medical costs from your income. Instead, SARS offers two medical tax credits, which reduce the tax you owe rather than your taxable income.
Below, Bloom explains the two credits, who qualifies, and how they are worked out. This is general information to help you understand the system, not tax advice, so it is always worth confirming your own situation with SARS or a registered tax practitioner.
Key takeaways
| • SARS offers two medical tax credits: the Medical Schemes Fees Tax Credit (MTC) and the Additional Medical Expenses Tax Credit (AMTC). |
| • The MTC applies only to registered medical scheme (medical aid) contributions, not to health insurance premiums. |
| • Qualifying out-of-pocket medical expenses may still count towards the AMTC, even if you are not on a scheme. |
| • Keep all receipts and records for five years, and confirm your own position with SARS or a tax practitioner. |
The two SARS medical tax credits
1. The Medical Schemes Fees Tax Credit (MTC). This is a fixed monthly rebate for people who belong to a registered medical scheme. It is based on how many people are on the scheme, not on how much you earn, and for salaried members it is usually applied automatically through your monthly PAYE. It is non-refundable, meaning it can reduce the tax you owe to zero but is not paid out as a cash refund.
2. The Additional Medical Expenses Tax Credit (AMTC). This covers qualifying out-of-pocket medical expenses that were not covered by a scheme, and, for scheme members, any contributions that were high relative to the MTC. You claim this on your annual tax return.
Important for health insurance members: Momentum Health4Me is health insurance, not a registered medical scheme, so its premiums do not earn the MTC. If you want cover that qualifies for the MTC, that comes from a registered medical scheme, such as Bloom’s medical aid options. Even so, qualifying medical costs you pay yourself may still count towards the AMTC.
What the Medical Schemes Fees Tax Credit is worth
SARS reviews the MTC amounts each year. For the 2026 year of assessment (1 March 2025 to 28 February 2026, the return filed in the 2026 filing season), the monthly credit for medical scheme members is:
| • R364 per month for the main member |
| • R364 per month for the first dependant |
| • R246 per month for each additional dependant |
For the 2027 year of assessment (1 March 2026 to 28 February 2027), the amounts rise to R376 for the main member, R376 for the first dependant and R254 for each additional dependant. As these figures change annually, always check the latest on the SARS medical credits page.
Qualifying out-of-pocket medical expenses
The AMTC looks at qualifying medical costs you paid yourself that were not refunded by a scheme. Common examples include:
| • Consultations and treatment from a registered medical practitioner, dentist, physiotherapist, chiropractor, homoeopath or optometrist. |
| • Prescribed medication from a registered practitioner or pharmacy. |
| • Hospitalisation in a registered hospital or nursing home. |
| • Home nursing care from a registered nurse, midwife or nursing assistant. |
| • Qualifying costs relating to a physical impairment or disability. |
As an example, the Health4Me specialist benefit is limited to a set number of visits a year. If you needed to see a specialist more often, or faced costs above the benefit, those amounts you paid yourself could count as qualifying out-of-pocket expenses.
How the Additional Medical Expenses Tax Credit is worked out
The AMTC is calculated differently depending on your age and whether there is a disability in the household. There are two main scenarios:
| Your situation | How the credit is calculated |
| Under 65, no disability | 25% of: (medical scheme contributions above 4 times the annual MTC) plus (qualifying out-of-pocket expenses), less 7.5% of your taxable income. Only the amount above that 7.5% threshold counts. |
| 65 or older, or a person, spouse or child with a disability (any age) | 33.3% of: (medical scheme contributions above 3 times the annual MTC) plus 33.3% of qualifying out-of-pocket expenses. There is no 7.5% of taxable income threshold in this case. |
If you have only health insurance and not a scheme, you would not have the medical scheme contribution portion, but your qualifying out-of-pocket expenses can still be included. A tax practitioner or the SARS eFiling calculator can help you work out your exact figure.
Claiming for a physical impairment or disability
If you, your spouse or a dependant has a qualifying disability, you may be able to claim additional qualifying costs. SARS defines a disability as a moderate to severe limitation of a person’s ability to function or perform daily activities, resulting from a physical, sensory, communication, intellectual or mental impairment, that has lasted or is expected to last more than a year and is diagnosed by a registered medical practitioner.
Qualifying costs can include things like travel and transport related to the disability, personal care, prosthetics, specialised products, service animals and home modifications. To claim, your medical practitioner must complete a Confirmation of Diagnosis of Disability (ITR-DD) form, and you must be able to show the expenses relate to the disability and were paid by you.
Who counts as a dependant
For medical tax credit purposes, dependants generally include:
| • Your spouse, including a same-sex partner. |
| • Your children, including stepchildren and adopted children. |
| • Another family member, such as a parent, parent-in-law, grandparent or sibling, who relies on you for family care and support. |
Records to keep and how Bloom can help
SARS can ask you to prove your claim, so keep records such as receipts, invoices, bank statements and proof of payment for five years from the date you submit your return. If a receipt is in a dependant’s name, SARS will generally accept an affidavit confirming that you paid the expense.
To make this easier, Bloom offers a MediTax service that gives members a breakdown of their qualifying medical expenses to support an AMTC claim, and can help collate the documents SARS may require. A premium MediTax option can also submit a basic tax return on your behalf, provided your membership is up to date for the assessment year.
Affordable cover, with tax-time supportBloom keeps quality private healthcare within reach, and helps you make the most of your medical expenses at tax time. Fill in your details and we will call you back. |
Frequently asked questions
Make the most of your healthcare at tax time
Understanding how the two medical tax credits work helps you avoid surprises and claim what you are entitled to. Remember that health insurance premiums do not earn the MTC, but qualifying out-of-pocket costs may still count towards the AMTC, and a registered medical scheme brings the MTC as well. When in doubt, speak to SARS or a registered tax practitioner about your own circumstances.
Explore affordable health insurance from Bloom and Health4Me, or take a look at our medical aid options. Compare Health4Me options, explore the full range of benefits, or speak to a medical professional through our Hello Doctor service. To get started, get in touch and we will call you back.
