In South Africa, medical costs are not deducted from your income the way they once were. Instead, SARS gives two tax credits that reduce the tax you owe: the Medical Schemes Fees Tax Credit for registered medical scheme (medical aid) contributions, and the Additional Medical Expenses Tax Credit for qualifying out-of-pocket costs, such as consultations, prescribed medication, hospitalisation and disability-related expenses that a scheme did not cover. Below we explain what qualifies and how it is worked out.
Many South Africans want to know what medical expenses they can claim back at tax time. It is a fair question, but the answer often surprises people. Since 2012, South Africa has used medical tax credits rather than deductions. A credit reduces the actual tax you owe, rather than reducing your taxable income, which is why the older idea of “deducting” medical costs no longer quite fits.
Below, Bloom explains which medical costs qualify, who can claim, and how the credits are calculated. This is general information, not tax advice, so please confirm your own situation with SARS or a registered tax practitioner.
Key takeaways
| • South Africa uses two medical tax credits, not deductions: the MTC for medical scheme contributions and the AMTC for qualifying out-of-pocket costs. |
| • The MTC applies only to registered medical scheme (medical aid) contributions, not to health insurance premiums. |
| • Qualifying out-of-pocket expenses include consultations, prescribed medication, hospitalisation, mental health care and disability costs. |
| • For those under 65 without a disability, out-of-pocket costs only count above a threshold of 7.5% of taxable income. |
How medical tax credits work
There are two credits, and they work together:
The Medical Schemes Fees Tax Credit (MTC) is a fixed monthly rebate for people who belong to a registered medical scheme. It depends on how many people are on the scheme, not on your income, and it is usually applied automatically through PAYE for salaried members.
The Additional Medical Expenses Tax Credit (AMTC) covers qualifying medical costs you paid yourself that were not covered by a scheme, and, for scheme members, contributions that were high relative to the MTC. You claim this on your annual return.
A key distinction: the MTC applies only to a registered medical scheme. Momentum Health4Me is health insurance, not a medical scheme, so Health4Me premiums do not earn the MTC. Bloom’s medical aid options are registered medical schemes and do qualify. Either way, qualifying out-of-pocket costs may count towards the AMTC.
Why medical tax credits matter
| • They lower your tax. Credits reduce the tax you owe rand for rand, which can leave you with more in your pocket. |
| • They make care more affordable. Recovering some of your medical spend helps offset the cost of staying healthy. |
| • They reward good record-keeping. Keeping track of out-of-pocket costs means you do not leave money on the table at tax time. |
Which medical expenses qualify?
Qualifying out-of-pocket expenses are medical costs you paid yourself that a scheme did not cover. Common examples include:
| • Consultations and procedures. Visits to a registered medical or dental practitioner, surgery, hospitalisation, and services from an optometrist, homoeopath and similar registered providers. |
| • Prescribed medication. Medicine prescribed by a registered practitioner that a scheme did not cover. |
| • Mental health care. Consultations, treatment and medication for conditions such as depression and anxiety. |
| • Expenses for a dependant. Qualifying costs you paid for a spouse, child or other dependant. |
| • Disability-related costs. Qualifying expenses for the treatment and care of a disability, such as specialised equipment, home modifications or therapy. |
For taxpayers under 65 without a disability, these out-of-pocket costs only start to count once they exceed 7.5% of your taxable income. For those aged 65 or older, or where there is a disability in the household, that threshold does not apply.
Who can claim?
Registered taxpayers can claim, with a few important points to keep in mind:
| • The MTC is for members of a registered medical scheme. It is based on the number of beneficiaries, and applies to the person who bears the cost of the contributions. |
| • The AMTC is open more broadly, since qualifying out-of-pocket expenses can be claimed even if you are not on a scheme, subject to the relevant threshold. |
| • You need valid proof, such as a medical scheme tax certificate for contributions and receipts for out-of-pocket costs. |
How the credits are calculated
The MTC is a set monthly amount. SARS reviews it each year. For the 2026 year of assessment (1 March 2025 to 28 February 2026), it is R364 a month for the main member, R364 for the first dependant and R246 for each additional dependant. For the 2027 year of assessment it rises to R376, R376 and R254. Always check the latest on the SARS medical credits page.
The AMTC is worked out with a formula that depends on your age and disability status:
| Your situation | How the credit is calculated |
| Under 65, no disability | 25% of: (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 threshold counts. |
| 65 or older, or a person, spouse or child with a disability (any age) | 33.3% of: (scheme contributions above 3 times the annual MTC) plus 33.3% of qualifying out-of-pocket expenses. No 7.5% of taxable income threshold applies. |
It sounds complex, and it can be, so the SARS eFiling calculator or a registered tax practitioner is the best way to get your exact figure.
Record keeping and support
Keep accurate records of your contributions and out-of-pocket expenses, including receipts and invoices, for five years from the date you submit your return. Good records make your claim easier and protect you if SARS asks for proof. If you are unsure how to claim, a tax professional can help you stay compliant.
Bloom’s MediTax service can help members collate the documents needed for an AMTC claim, and a premium option can submit a basic tax return on your behalf, provided your membership is up to date for the assessment year.
Cover that works for your budgetFrom health insurance to medical aid, Bloom helps you find affordable cover and make the most of your medical expenses at tax time. Fill in your details and we will call you back. |
Frequently asked questions
Claim what you are entitled to
Understanding that South Africa uses credits rather than deductions, and knowing which costs qualify, helps you claim everything you are entitled to at tax time. Keep good records, know the difference between a medical scheme and health insurance, and confirm your own position with SARS or a registered tax practitioner.
Explore Bloom’s medical aid options or affordable health insurance. Compare medical aid 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.
