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.
🏥 Medical Aid & Salary Details
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 tax 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 three times your annual Section 6A credit:
Annual 6A credit = Monthly 6A credit × 12
Annual contributions = Monthly premium × 12
Annual OOP expenses = Monthly out-of-pocket × 12
Excess = MAX(0, Contributions − 3 × Annual 6A credit)
6B credit = 25% × (Excess + Annual OOP expenses)
2. For taxpayers 65 or older, or with a confirmed disability (ITR-DD) — the rate rises to 33.3% and the threshold is lower:
Excess = MAX(0, Annual contributions − 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.
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 42-year-old on a family medical aid (main member + 2 dependants, so 3 members total) paying R3,800/month in premiums, with R500/month average out-of-pocket qualifying expenses. Annual salary R50,000/month:
| Item | Calculation | Amount |
|---|---|---|
| Section 6A monthly credit | R376 + R376 + R254 | R 1,006 / month |
| Monthly premium | — | R 3,800 / month |
| Net monthly medical aid cost | R3,800 − R1,006 | R 2,794 / month |
| Annual Section 6A credit | R1,006 × 12 | R 12,072 |
| Annual premium | R3,800 × 12 | R 45,600 |
| 3× annual 6A credit threshold | R12,072 × 3 | R 36,216 |
| Excess contributions | R45,600 − R36,216 | R 9,384 |
| Annual OOP expenses | R500 × 12 | R 6,000 |
| Section 6B qualifying amount | R9,384 + R6,000 | R 15,384 |
| Section 6B credit (25%) | R15,384 × 25% | R 3,846 / year |
| Total annual medical tax benefit | R12,072 + R3,846 | R 15,918 / year |
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.
Frequently Asked Questions
How much is the medical aid tax credit in South Africa for 2026/2027?
For 2026/2027, the monthly Section 6A credit is R376 for the main member, R376 for the first dependant, and R254 for each additional dependant. A single person pays less PAYE by R376/month (R4,512/year). A couple saves R752/month. A family of four saves R1,260/month (R15,120/year) — simply for being registered on a medical aid scheme.
Is the medical tax credit a deduction or a direct credit?
It is a direct credit — not a deduction. A deduction reduces the income you are taxed on (so its rand value depends on your bracket). A credit reduces your actual tax bill by the same fixed rand amount regardless of your income level. R376 is worth exactly R376 in tax saving to everyone with a medical aid, whether they are in the 18% or 45% bracket.
What is Section 6B and how do I claim it?
Section 6B is an additional credit for taxpayers whose medical aid contributions and/or out-of-pocket qualifying expenses exceed a threshold. For under-65s without disability, it is 25% of the excess over 3× the annual Section 6A credit. For those 65+ or with a confirmed disability (ITR-DD form), it is 33.3% of the excess. Section 6B is claimed on your annual ITR12 tax return — it is not automatically applied to monthly PAYE. Retain all medical receipts, medical aid statements of benefit, and scripts throughout the year as SARS can request supporting documents.
Do I get the credit if I pay for my own medical aid privately?
Yes. Whether your medical aid is deducted via payroll or paid privately by debit order, you are entitled to the Section 6A credit as a registered contributing member. If paid privately, your employer does not apply the credit to monthly PAYE (they do not know about it), so you will overpay PAYE during the year and reclaim the credit via your annual ITR12 tax return. SARS will either reduce your tax assessment or issue a refund for the credits that were not applied monthly.
Can dependants include adult children on my medical aid?
Yes — adult children who are registered as dependants on your medical aid scheme qualify for the Section 6A credit, provided the main member is the contributing member paying the premium. Medical aid schemes generally allow dependants up to age 21 (or 26 if a full-time student) and permanently disabled dependants at any age. Each registered dependant counts toward your credit calculation: the second person on the scheme gets R376/month credit; the third and beyond each get R254/month.