Medical Tax Credits in South Africa: Section 6A and 6B Explained

Medical costs are one of the most common areas where South Africans leave money on the table — or misunderstand how relief works. South Africa largely uses tax credits, not open-ended medical deductions, for qualifying medical scheme contributions and certain additional medical expenses. This guide explains Section 6A and Section 6B in plain English so you know what to review on your 2026 return.

Credit rates and qualifying rules can change with Budgets and SARS updates. Always confirm the amounts applicable to your year of assessment with current SARS tables or a practitioner.

Credits vs Deductions — Why It Matters

A deduction reduces taxable income. A tax credit reduces tax payable rand-for-rand (subject to how the credit is calculated).

Medical scheme fees tax credits (Section 6A) and additional medical expenses tax credits (Section 6B) are credits. That means:

• They do not work like simply “deducting my hospital bill from taxable income”
• The value depends on formula rules, dependants, and (for 6B) thresholds and qualifying expenditure
• Employer-captured medical credits on an IRP5 may already reflect part of your position — but you should still check completeness

Section 6A: Medical Scheme Fees Tax Credit

Section 6A generally provides a monthly tax credit for contributions to a registered medical scheme for you and qualifying dependants.

Monthly medical scheme fees tax credit amounts (confirm on SARS tables for your YOA):

Period theme	Main member / first two beneficiaries (each)	Each additional dependant
YOA often cited for Filing Season 2026 (prior rates)	R364	R246
Updated amounts in Budget 2026 Tax Guide materials	R376	R254

Typical themes SARS material covers:

• A monthly credit amount for the main member
• Additional monthly amounts for the first dependant and further dependants
• Credits calculated with reference to months of membership / contributions in the year of assessment

Your medical scheme usually issues a tax certificate summarising contributions and dependants. Employers often process 6A credits through payroll so PAYE is reduced during the year. At return time, compare your IRP5 / certificates to what SARS has pre-populated — especially if you changed schemes, added dependants mid-year, or paid privately outside payroll.

Section 6B: Additional Medical Expenses Tax Credit

Section 6B can provide an additional medical expenses tax credit for certain qualifying medical expenditure beyond the Section 6A framework, subject to statutory formulae. Categories often discussed in SARS guidance include situations such as:

• Taxpayers aged 65 or older
• Taxpayers with a disability (as defined for tax purposes) for themselves or a dependent
• Other individuals whose qualifying out-of-pocket medical expenses and related amounts exceed prescribed thresholds after taking scheme contributions and 6A into account

Qualifying expenses commonly researched by taxpayers include unrecovered medical expenses paid to registered medical practitioners, hospitals, and related qualifying costs — not every wellness purchase or over-the-counter item. Proof matters: invoices, scheme statements showing shortfalls, and disability confirmation where relevant.

Because 6B is formula-driven, a large hospital bill does not automatically equal a rand-for-rand credit. Run (or have a practitioner run) the calculation against the rules for your year.

What to Check During Tax Season 2026

1. Obtain your medical scheme tax certificate(s) for the year of assessment.
2. Confirm dependants listed match your actual situation for the months claimed.
3. Compare IRP5 medical credit fields to your certificate totals.
4. List unrecovered out-of-pocket expenses that may qualify for 6B consideration.
5. If you have a disability-related claim, ensure documentation aligns with SARS requirements.
6. On an auto-assessment, verify that medical credits look complete before you leave the assessment uncorrected.

Related reading on this blog: review auto-assessments carefully — medical top-ups and private contributions are frequent gaps.

Common Mistakes

• Assuming all medical spending is deductible from taxable income
• Forgetting mid-year dependant changes
• Claiming expenses already paid in full by the scheme without checking what qualifies as “additional”
• Losing invoices for specialists, pharmacies, or hospital shortfalls
• Ignoring 6B entirely when over 65 or when disability criteria may apply

How Refund AI Can Help

Refund AI can help you explore how Section 6A and 6B are generally described, what documents taxpayers usually gather, and which questions to verify with SARS. It does not calculate your credit entitlement or file your return. Confirm figures with SARS tables, your certificates, or a registered tax practitioner.

Conclusion

Medical tax relief in South Africa is mostly about credits under Section 6A and, where you qualify, Section 6B. Check scheme certificates against your IRP5 and auto-assessment, keep records of qualifying out-of-pocket costs, and apply the right formula for your year of assessment. Careful review here is one of the more practical ways to protect a correct refund position.

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Key Citations:

• SARS guides on medical scheme fees tax credits (Section 6A)
• SARS guides on additional medical expenses tax credits (Section 6B)
• Income Tax Act Sections 6A and 6B (as applied for the year of assessment)
• Medical scheme tax certificates and IRP5 medical credit fields