Medical Aid Tax Credit Calculator South Africa
Calculate your exact Section 6A monthly credit and Section 6B additional medical expenses credit. See what your medical aid actually costs you after SARS gives you your money back.
For the 2026/2027 tax year, SARS gives a fixed monthly Section 6A medical scheme fees tax credit of R376 for the main member, R376 for the first dependant and R254 for each additional dependant — regardless of your actual premium. This directly reduces your monthly PAYE. Section 6B may add further relief for qualifying out-of-pocket medical expenses (SARS, 2026/2027).
South Africa's Medical Tax Credit reduces the PAYE deducted from your monthly salary for every registered dependant covered by a qualifying medical scheme. The credit is a fixed rand amount per beneficiary — SARS sets the figure each tax year, regardless of your actual premium. This calculator shows your Section 6A monthly credit and Section 6B additional medical expenses relief, and how both reduce your effective PAYE for the 2026/2027 tax year.
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How to Use This Calculator
Enter your number of dependants
Include yourself (main member), your spouse and any children or other registered dependants.
Section 6A credit is calculated
R376/month for the main member, R376 for the first dependant and R254 for each additional dependant.
Enter Section 6B expenses (optional)
Enter qualifying out-of-pocket medical expenses not reimbursed by your scheme for the additional credit.
Net medical aid cost is shown
Effective monthly cost = contributions paid minus the Section 6A credit your employer applies to reduce PAYE.
How the Medical Aid Tax Credit Works in South Africa
The medical aid tax credit (MTC) is one of the most misunderstood tax benefits in South Africa. Unlike a deduction, which reduces your taxable income before tax is calculated, the MTC is a direct credit against your PAYE liability. SARS reduces the amount of income tax you owe by a fixed rand amount for every member covered under a registered medical aid scheme.
The practical effect: every South African on a medical aid pays less tax each month by exactly the credit amount, regardless of their income or tax bracket. A minimum-wage earner and a senior executive both save the same R376 per month for being the main member. There is no income phase-out or bracket dependency — the credit is the same rand value for everyone who has a medical aid.
The 2026/2027 Section 6A Credit Rates
Main member = R376.00 / month
First dependant = R376.00 / month
Each further dependant = R254.00 / month
/* Examples */
Solo (main only): R376 × 1 = R 376 / month
Couple (main + 1): R376 + R376 = R 752 / month
Family of 3 (main + 2): R752 + R254 = R 1,006 / month
Family of 4 (main + 3): R1,006 + R254 = R 1,260 / month
Family of 5 (main + 4): R1,260 + R254 = R 1,514 / month
Section 6B — When the Extra Credit Kicks In
Section 6B of the Income Tax Act provides an additional medical expenses credit beyond the Section 6A flat credit. It applies in two scenarios:
1. For taxpayers under 65 with no disability — you can claim 25% of the amount by which your qualifying medical expenditure exceeds four times your annual Section 6A credit, after also subtracting 7.5% of your taxable income:
Annual 6A credit = Monthly 6A credit × 12
Annual contributions = Monthly premium × 12
Annual OOP expenses = Monthly out-of-pocket × 12
Excess = MAX(0, Contributions − 4 × Annual 6A credit) + Annual OOP expenses
Income floor = 7.5% × Annual taxable income
6B credit = 25% × MAX(0, Excess − Income floor)
2. For taxpayers 65 or older or with a confirmed disability (ITR-DD) — the rate rises to 33.3%, the threshold drops to three times the annual 6A credit, and there is no income floor:
Excess = MAX(0, Annual contributions − 3 × Annual 6A credit)
6B credit = 33.3% × (Excess + Annual OOP expenses)
Section 6B credits are typically claimed on your annual ITR12 tax return — they are not automatically applied to monthly PAYE. Keep all medical receipts, medical aid statements of benefit (showing what the scheme did and did not pay) and hospital admission records throughout the year.
One important limit applies to both credits: they're non-refundable. Section 6A and Section 6B together can reduce your tax liability to zero, but no further — if your combined credits are larger than the tax you actually owe for the year, the excess isn't paid out as a refund and doesn't carry forward to the next tax year. This matters most for lower-income earners with genuinely large qualifying medical expenses, where the calculated Section 6B credit can exceed what their remaining tax liability can actually absorb.
What Counts as a Qualifying Medical Expense for Section 6B?
SARS allows Section 6B deductions for expenses paid to recognised medical practitioners and institutions for the diagnosis, treatment or prevention of illness. Key qualifying expenses include:
- Medical aid co-payments and gap amounts (scheme rate vs actual rate differences)
- Prescribed medicines and chronic medication scripts not fully covered
- Specialist consultations where the medical aid paid only a portion
- Dental work — fillings, extractions, root canals, orthodontics (partially)
- Corrective spectacles and contact lenses (with optometrist prescription)
- Physiotherapy, occupational therapy and registered allied health services
- Hospital admission and procedure gaps
- Disability-related accommodation and services (for disability claimants)
Expenses that do not qualify include: gym memberships, general vitamins and supplements (unless specifically prescribed by a doctor for a diagnosed condition), cosmetic procedures, alternative/homeopathic practitioners who are not registered with a recognised professional council, and medical travel for non-essential purposes.
Step-by-Step Manual Calculation Example
Take a 38-year-old, no disability, on a family medical aid (main member + 3 dependants, so 4 members total) paying R6,500/month in premiums, with R2,000/month average out-of-pocket qualifying expenses, earning a R20,000/month salary:
| Item | Calculation | Amount |
|---|---|---|
| Section 6A monthly credit | R376 + R376 + R254 + R254 | R 1,260 / month |
| Monthly premium | — | R 6,500 / month |
| Net monthly medical aid cost | R6,500 − R1,260 | R 5,240 / month |
| Annual Section 6A credit | R1,260 × 12 | R 15,120 |
| Annual premium | R6,500 × 12 | R 78,000 |
| 4× annual 6A credit threshold (under-65, no disability) | R15,120 × 4 | R 60,480 |
| Excess contributions | R78,000 − R60,480 | R 17,520 |
| Annual OOP expenses | R2,000 × 12 | R 24,000 |
| Section 6B qualifying amount before income floor | R17,520 + R24,000 | R 41,520 |
| Annual taxable income | R20,000 × 12 | R 240,000 |
| Less: 7.5% of taxable income | R240,000 × 7.5% | − R 18,000 |
| Net qualifying amount | R41,520 − R18,000 | R 23,520 |
| Section 6B credit (25%) | R23,520 × 25% | R 5,880 / year |
| Total annual medical tax benefit | R15,120 + R5,880 | R 21,000 / year |
The 7.5%-of-taxable-income floor is easy to miss. It's why the worked example above needs a fairly large premium and out-of-pocket total relative to income before any Section 6B credit appears. For many working-age taxpayers with more typical premiums, the floor absorbs the qualifying excess entirely and the Section 6B credit is R0 — only the flat Section 6A credit applies. There's no equivalent floor for taxpayers 65 or older or with a confirmed disability, which is why that group reaches a Section 6B credit far more easily.
Medical Aid Tax Credit vs RA Deduction — Key Difference
Many people confuse the medical aid credit with a deduction. The distinction matters greatly:
- An RA deduction reduces your taxable income, so its value scales with your tax bracket. A 36% taxpayer saves 36 cents per rand of RA contribution; an 18% taxpayer saves 18 cents.
- The medical aid credit reduces your tax bill directly by a fixed rand amount. R376 is worth R376 to everyone — a minimum-wage earner and a top executive both save the same absolute amount per member.
This means the MTC is proportionally more valuable to lower-income earners. A worker paying R600/month for medical aid (2 members) receives an R752 credit — the credit actually exceeds the premium. In this case the "net cost" becomes negative, meaning the medical aid is entirely subsidised by the tax benefit.
What If You Only Have Medical Aid for Part of the Year?
The monthly medical aid tax credit only applies for the months you were actually a contributing member. If you joined a scheme in July, for example, you would receive the Section 6A credit for the 8 months from July to February, not the full 12 months — your payroll system prorates this automatically based on your medical aid contribution start date. This matters most for calculating your Section 6B additional medical expenses credit at year-end, since that calculation multiplies the monthly credit by the number of months you were a member to determine your annual credit baseline for the excess-contribution formula.