What happens if my medical aid tax credit is more than my tax liability?

The Section 6A medical aid tax credit can reduce your tax liability to zero, but any unused credit is not refunded to you. If your total tax after rebates is already zero or very low, the medical aid tax credit simply reduces any remaining liability to zero. The Section 6B additional medical expenses credit also cannot result in a negative tax liability.

Medical Aid Tax Credit 2026/2027: Complete South Africa Guide (Section 6A & 6B)

Q: Who qualifies for the medical aid tax credit in South Africa?

Any South African taxpayer who pays medical aid contributions for themselves or their dependants qualifies for the Section 6A medical aid tax credit. The credit applies to the main member and all registered dependants on the medical aid scheme. You do not need to be employed — self-employed and freelance taxpayers also qualify if they pay their own medical aid contributions.

Q: What is the Section 6B additional medical expenses tax credit?

Section 6B is an additional medical expenses tax credit that covers qualifying out-of-pocket medical costs not reimbursed by your medical aid scheme. For taxpayers under 65, the credit equals 25% of the amount by which your qualifying expenses exceed 4 times your Section 6A credit for the year. For taxpayers aged 65 and over, or those with a disability, the credit is 33.3% of all qualifying medical expenses.

Q: How do I claim the medical aid tax credit on my ITR12?

SARS automatically calculates the Section 6A medical aid tax credit based on the contribution data on your IRP5. On your ITR12, go to the Medical Expenses section and enter the number of months you and each dependant were covered, the total contributions paid, and any qualifying out-of-pocket medical expenses for Section 6B. SARS will calculate the credit amounts for you.

Q: What out-of-pocket medical expenses qualify for Section 6B?

Qualifying expenses for Section 6B include: doctor, specialist, dentist, and optometrist fees not covered by medical aid; prescribed medicines and scripts; hospital costs not covered by medical aid; and costs for a person with a disability. All expenses must be supported by receipts and must be for you or your dependants registered on your ITR12.

Income Tax · 2026/2027 Tax Year

Medical Aid Tax Credit 2026/2027: Complete South Africa Guide

Section 6A & 6B explained with current rand amounts, worked examples for individuals and families, and step-by-step ITR12 claim instructions.

Updated May 2026 2026/27 Rates 8 min read

⚡ Quick Answer — Medical Aid Tax Credit 2026/2027

The medical aid tax credit (Section 6A) for 2026/2027 is R376 per month for the main member and first dependant, and R254 per month for each additional dependant. This is a direct tax credit — not a deduction — meaning it reduces your SARS tax bill rand-for-rand regardless of your income level. A family of four on medical aid saves up to R15,120 per year in tax through this credit alone. The credit is applied automatically on your ITR12 assessment based on your IRP5 medical aid data.

Table of Contents

What Is the Medical Aid Tax Credit?
Credit vs Deduction: The Key Difference
2026/2027 Rate Table & Who Qualifies
Section 6B: Additional Medical Expenses
Worked Examples: Individual, Couple & Family
How to Claim on Your ITR12
Common Mistakes to Avoid
Frequently Asked Questions

01 · Introduction

What Is the Medical Aid Tax Credit?

The medical aid tax credit is a benefit provided under Section 6A of the South African Income Tax Act. It allows taxpayers who pay medical aid contributions to reduce their annual SARS tax liability by a fixed rand amount per month for each person covered on the medical aid scheme.

The credit applies to the main member and all registered dependants. Unlike many other tax provisions, the medical aid tax credit is not means-tested — it is available to all qualifying taxpayers at the same rand value, regardless of income level. There is no upper income limit, and no minimum income required.

The credit was introduced in 2012 to replace the previous system of allowing medical aid contributions as a partial income tax deduction. The switch to a flat credit system was designed to give lower-income taxpayers a proportionally larger benefit, since a flat credit is worth more relative to the tax they pay.

Important: The medical aid tax credit reduces the tax you owe — it does not reduce your taxable income. If your total tax liability after all rebates is already zero, any unused medical aid tax credit cannot be refunded to you.

02 · Credit vs Deduction

Medical Aid Tax Credit vs Deduction: The Key Difference

Many South African taxpayers use the terms “tax credit” and “tax deduction” interchangeably, but they work very differently. Understanding this distinction matters for accurate tax planning:

Tax Credit (Section 6A)

How it works: Subtracts a fixed rand amount directly from your tax bill after all calculations.

R376/month benefit is identical whether you earn R200,000 or R2,000,000
Proportionally more valuable to lower-income earners
Applied after tax is calculated — reduces final SARS liability
Not affected by your marginal tax rate

Tax Deduction (old system)

How it worked: Reduced your taxable income, so the benefit depended on your tax bracket.

A high earner (45% bracket) saved more than a low earner (18% bracket)
Favoured higher-income taxpayers disproportionately
Applied before tax is calculated — reduced the income being taxed
Abolished in 2012 and replaced with the flat credit system

Practical example: A monthly medical aid credit of R376 saves every qualifying taxpayer exactly R376 per month in tax — R4,512 per year per covered member. Under the old deduction system, a taxpayer in the 45% bracket would have saved far more from the same contribution than a taxpayer in the 18% bracket. The credit system is more equitable.

03 · 2026/2027 Rates

Medical Aid Tax Credit 2026/2027: Rate Table & Who Qualifies

The 2026/2027 medical aid tax credit rates increased by 3.4% from the previous tax year, in line with the March 2026 Budget adjustments. The rates apply from 1 March 2026 to 28 February 2027:

Beneficiary	Monthly Credit	Annual Credit	2025/26 Rate	Increase
Main member	R376	R4,512	R364	+R12/month
First dependant	R376	R4,512	R364	+R12/month
2nd dependant	R254	R3,048	R246	+R8/month
3rd dependant	R254	R3,048	R246	+R8/month
Each additional	R254	R3,048	R246	+R8/month

Who qualifies: Any South African resident taxpayer who pays registered medical scheme contributions for themselves or their dependants. This includes salaried employees (where the employer pays), self-employed individuals, freelancers, and pensioners. The scheme must be registered under the Medical Schemes Act.

Gap cover and hospital plans: Contributions to gap cover policies do not qualify for the Section 6A medical aid tax credit. Only contributions to medical schemes registered with the Council for Medical Schemes (CMS) qualify.

Use the TaxPlanners income tax calculator to see exactly how your medical aid tax credit reduces your total tax bill alongside your other deductions and rebates.

04 · Section 6B

Section 6B: Additional Medical Expenses Tax Credit

In addition to the Section 6A medical aid tax credit for contributions, SARS provides a second credit under Section 6B for qualifying out-of-pocket medical expenses that were not covered by your medical aid scheme.

Taxpayer Category	Section 6B Formula	Qualifying Expenses
Under 65, no disability	25% of [qualifying expenses + uncovered costs − 4 × annual Section 6A credit]	Out-of-pocket medical costs exceeding 4x the annual Section 6A credit
Age 65 and over	33.3% of all qualifying medical expenses paid	All qualifying out-of-pocket medical expenses
Person with disability	33.3% of all qualifying medical expenses paid	All qualifying expenses including disability-related costs

What qualifies as a Section 6B expense: Doctor, specialist, dentist, and optometrist fees not reimbursed by medical aid; prescribed medicines (with a valid script); hospital costs not covered; and any other expenses for a person with a disability as defined by SARS. All expenses must be supported by receipts and paid in the same tax year you are claiming.

Section 6B threshold for under-65 taxpayers: For a single member, the annual Section 6A credit for 2026/27 is R4,512. Four times this is R18,048. This means your out-of-pocket expenses must exceed R18,048 in the year before any Section 6B credit applies. Most under-65 taxpayers without a disability do not reach this threshold.

05 · Worked Examples

Worked Examples: Medical Aid Tax Credit for Individual, Couple & Family

The following examples use 2026/2027 rates and assume 12 months of medical aid coverage throughout the full tax year:

Example 1

Single Individual

Members covered1 (main only)

Monthly credit rateR376

Months covered12

Annual Section 6A creditR4,512

Annual tax savingR4,512

Example 2

Couple (Main + Spouse)

Members covered2 (main + spouse)

Main member creditR376 × 12

Spouse creditR376 × 12

Annual Section 6A creditR9,024

Annual tax savingR9,024

Example 3

Family of Four

Members covered4 (main + 3 dep.)

First 2 membersR376 × 2 × 12

Additional 2 membersR254 × 2 × 12

Annual Section 6A creditR15,120

Annual tax savingR15,120

Mid-year joiner: If you joined a medical aid scheme mid-year, the credit is calculated pro-rata for the months you were covered. For example, joining in September 2026 (6 months remaining in the tax year to February 2027) gives a single member R376 × 6 = R2,256 in Section 6A credit for that tax year.

Use the TaxPlanners PAYE calculator or our tax refund calculator to check your full tax position including medical aid credits alongside your income tax and rebates.

06 · Claiming on ITR12

How to Claim the Medical Aid Tax Credit on Your ITR12

SARS automatically calculates your Section 6A medical aid tax credit based on the data on your IRP5 from your employer or medical scheme. However, you still need to confirm the medical section on your ITR12 and capture any Section 6B expenses manually:

Log in to SARS eFiling and open your ITR12

Go to sars.gov.za, log in to eFiling, and open your ITR12 return for the 2026/2027 tax year. If SARS has issued an auto assessment, click Edit Return to access the full ITR12 form. Check that your return has the Medical Expenses section enabled — select “Yes” when asked if you have medical expenses or medical aid contributions.

Verify your IRP5 medical aid data is pre-populated

Your employer-paid and employee-paid medical aid contributions appear on your IRP5 under Code 4005 (employer contributions) and Code 4474 (employee contributions). On your ITR12, these figures should be pre-populated from your IRP5. Verify the total contribution amount matches your annual medical aid statements.

Capture number of months and dependants covered

In the Medical Expenses section of your ITR12, enter the number of months you were covered (1–12), the number of dependants covered, and the total contributions paid for the year. SARS uses these figures to calculate your Section 6A credit at R376/month for the first two members and R254/month for additional members.

Capture Section 6B out-of-pocket expenses (if applicable)

If you have qualifying medical expenses not covered by your scheme, enter the total amount in the “Medical expenses not covered by medical aid” field. Keep all receipts for doctor, dentist, specialist, pharmacy, and hospital visits — SARS may request supporting documents. For taxpayers under 65, only the portion exceeding 4 times your annual Section 6A credit will generate an additional credit.

Review your tax calculation summary

Once all fields are captured, click Calculate on eFiling. Your ITR12 summary will show your gross tax, less primary/secondary/tertiary rebates, less Section 6A medical aid tax credit, and any Section 6B credit. The final figure is your net tax payable or refund due. Use our 2026/27 tax brackets guide to verify the gross tax calculation is correct before submitting.

07 · Common Mistakes

Common Medical Aid Tax Credit Mistakes to Avoid

Confusing credit with deduction

Many taxpayers believe medical aid contributions reduce their taxable income. They do not. The Section 6A credit reduces your tax bill directly after all income calculations are done.

FIX: Do not enter medical aid contributions in the deductions section of your ITR12. Use only the Medical Expenses section.

Not claiming dependants

Some taxpayers only claim the credit for themselves and forget to include registered dependants (spouse, children). Each covered dependant generates an additional monthly credit.

FIX: Count every person registered on your medical aid scheme and enter the correct number of dependants on your ITR12. Match this to your medical scheme certificate.

Claiming gap cover contributions

Gap cover is not a registered medical scheme. Including gap cover premiums in your Section 6A medical aid tax credit claim is incorrect and may trigger a SARS verification query.

FIX: Only include contributions to schemes registered under the Medical Schemes Act. Check your scheme’s registration status at the Council for Medical Schemes website.

Missing Section 6B expenses

Taxpayers aged 65+ or with a disability often miss claiming qualifying out-of-pocket expenses under Section 6B, which gives them 33.3% credit on all such costs — with no minimum threshold.

FIX: If you are 65 or older, collect and capture ALL qualifying medical receipts for the tax year. The Section 6B credit for your category has no minimum spending threshold.

Using wrong tax year rates

Using 2025/26 rates (R364/R246) instead of the 2026/27 rates (R376/R254) results in an understated credit claim and a higher-than-necessary tax payment to SARS.

FIX: Always verify the current year rates. For the 2026/2027 tax year, the correct rates are R376/month (first 2 members) and R254/month (3rd member and beyond).

Not checking auto assessment figures

SARS auto assessments pre-populate medical credit data from your IRP5, but errors occur — particularly if your employer submitted incorrect codes or if you changed medical schemes mid-year.

FIX: Always click Edit Return on your auto assessment and verify the medical aid contribution amounts match your annual medical scheme tax certificate before accepting.

08 · FAQ

Frequently Asked Questions — Medical Aid Tax Credit

How much is the medical aid tax credit for 2026/2027?

For the 2026/2027 tax year, the medical aid tax credit is R376 per month for the main member and first dependant, and R254 per month for each additional dependant. These represent annual credits of R4,512 per person for the first two members and R3,048 per year for each additional member. These rates increased by 3.4% from the 2025/2026 tax year in line with the March 2026 Budget.

What is the difference between a medical aid tax credit and a medical aid deduction?

A tax credit reduces your final tax bill directly by a fixed rand amount, regardless of your income. A tax deduction reduces your taxable income, so the benefit depends on your tax bracket. The medical aid tax credit (Section 6A) is a credit, not a deduction — every qualifying taxpayer gets the same rand value benefit, whether they earn R150,000 or R1,500,000 per year. Medical aid contributions have not been deductible in South Africa since 2012.

Who qualifies for the medical aid tax credit in South Africa?

Any South African resident taxpayer who pays contributions to a registered medical scheme for themselves or their dependants qualifies for the Section 6A medical aid tax credit. This includes salaried employees (whether the employer pays or the employee pays), self-employed individuals, freelancers, and pensioners. There is no upper income limit and no minimum income requirement.

What is the Section 6B additional medical expenses tax credit?

Section 6B is an additional tax credit for qualifying out-of-pocket medical costs not reimbursed by your medical aid. For taxpayers under 65 without a disability, the credit is 25% of expenses exceeding 4 times your annual Section 6A credit (R18,048 for a single member in 2026/27). For taxpayers aged 65 and over, or those with a disability, the credit is 33.3% of all qualifying medical expenses with no minimum threshold.

Can I claim the medical aid tax credit if my employer pays my medical aid?

Yes. If your employer pays medical aid contributions on your behalf, the credit is still applied in your favour. SARS receives the contribution data from your IRP5 (code 4005 for employer contributions, code 4474 for employee contributions). SARS calculates and applies the Section 6A credit automatically on your assessment. Your employer’s contribution is also included as a taxable fringe benefit, but the credit offsets the tax on this benefit.

How do I claim the medical aid tax credit on my ITR12?

Log in to SARS eFiling and open your ITR12. Enable the Medical Expenses section. Your employer-paid contributions should be pre-populated from your IRP5. Verify the total contribution amount, enter the number of months covered and number of dependants, and add any qualifying out-of-pocket expenses for Section 6B. SARS calculates the credit amounts automatically from these inputs.

Are medical aid contributions tax deductible in South Africa?

No. Medical aid contributions are not tax deductible in South Africa. They qualify for a medical aid tax credit (Section 6A) instead, which directly reduces the amount of tax you owe. The credit system replaced the previous deduction system in 2012. Do not enter medical aid contributions in the income deductions section of your ITR12 — capture them in the Medical Expenses section only.

What out-of-pocket medical expenses qualify for Section 6B?

Qualifying Section 6B expenses include: doctor, specialist, dentist, and optometrist fees not covered by medical aid; prescribed medicines and scripts not reimbursed by your scheme; hospital costs above your medical aid benefit; and disability-related expenses for a person with a disability as defined under the Income Tax Act. All claims must be supported by receipts paid within the tax year.

Does the medical aid tax credit apply to gap cover premiums?

No. Gap cover is not a registered medical scheme under the Medical Schemes Act, so gap cover premiums do not qualify for the Section 6A medical aid tax credit. However, if a gap cover payout does not fully cover a medical expense, the remaining out-of-pocket portion may qualify as a Section 6B expense if it meets all other requirements.

What happens if my medical aid tax credit exceeds my tax liability?

The Section 6A medical aid tax credit can reduce your tax liability to zero, but any unused credit portion is not refunded to you by SARS. If your total tax after rebates is already zero or very low, the credit reduces remaining liability to zero. This typically affects low-income earners whose taxable income falls near or below the tax-free threshold of R99,000 for 2026/27.

Calculate Your Medical Aid Tax Credit

Use the TaxPlanners income tax calculator to see your exact Section 6A credit alongside your full 2026/2027 tax calculation — including rebates, PAYE, and your refund or liability.

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Disclaimer: The information on this page is for general guidance only and reflects SARS rules and rates for the 2026/2027 tax year based on publicly available information. TaxPlanners does not provide personalised tax advice. Consult a registered tax practitioner for advice specific to your circumstances.