As South Africans continue with the 2025 tax season, new details have emerged about how taxpayers can benefit from medical tax claims beyond the usual medical aid credits. Many citizens know that the South African Revenue Service (SARS) gives tax refunds for medical aid contributions, but far fewer realise that out-of-pocket medical payments can also qualify for additional tax relief if properly documented.
According to Tax Consulting South Africa, Section 6B of the Income Tax Act allows what is called an Additional Medical Tax Credit (AMTC). This is in addition to the standard medical aid tax credits. The condition, however, is that the medical expenses must fall under what the law describes as “qualifying medical expenses.” These could include payments for services such as laboratory tests, doctors’ fees, prescribed medicines, and care for dependents living with disabilities.
The consulting group revealed that successful claims in past years have ranged between R2,000 and R100,000 in tax credits, depending on the taxpayer’s situation and expenses. This shows the potential financial relief available if taxpayers take the right steps to claim what is due to them.
The Council for Medical Schemes confirmed in its latest report that South Africans spent more than R40 billion in out-of-pocket medical payments during the 2023/2024 tax year. Many of these expenses, if properly declared, could qualify for relief under the Additional Medical Tax Credit system.
However, experts warn that the process is not automatic. SARS does not simply approve claims without strict checks. Taxpayers must provide full proof of every amount they list. This includes tax invoices, medical scheme certificates, and detailed schedules of expenses. Tax Consulting South Africa noted that many taxpayers make the mistake of entering expenses on their tax return without keeping the evidence. This often leads to their claims being rejected.
Where expenses relate to a disability, SARS requires a special form known as ITR-DD, which must be signed by a registered medical practitioner. Furthermore, the Tax Administration Act demands that supporting documents must be kept for at least five years. Without these documents, even valid claims can be disallowed.
Another important factor is that not all taxpayers qualify equally. For most people, the relief only applies if medical expenses and excess contributions are greater than 7.5% of taxable income. In such cases, only 25% of the amount above that threshold can be claimed. This means higher-income earners need to spend much more on medical costs before they qualify for relief.
There are, however, more favourable conditions for taxpayers above 65 years of age, or those who have a disability or dependents with a disability. For them, 33.3% of qualifying expenses and excess contributions can be claimed, making it easier to benefit from the system. Tax Consulting stressed the importance of understanding which category each taxpayer falls into before making a claim.
The term “qualifying medical expenses” is very wide under the law. It covers services from doctors, dentists, physiotherapists, optometrists, pharmacists, hospitals, nurses, and even traditional healers like herbalists and osteopaths if registered. It also includes expenses linked to mental impairments or physical disabilities affecting the taxpayer or their dependents.
What is essential, however, is that these expenses must be out-of-pocket — meaning the taxpayer or spouse must have personally paid for them without reimbursement from medical aid or another party. The law is clear that only expenses directly borne by the taxpayer can be included.
With filing season already underway, taxpayers are reminded of key deadlines. For non-provisional taxpayers, filing closes on 20 October 2025, while provisional taxpayers have longer. This means South Africans still have time to organise their documents, check their eligibility, and make use of the Additional Medical Tax Credit to reduce their tax burden.
Tax Consulting South Africa concluded by advising taxpayers to be proactive and diligent in record-keeping. Proper documentation not only increases the chances of a successful claim but also protects individuals in case SARS calls for an audit.
As the cost of healthcare continues to rise, experts say that medical tax credits are an important relief measure for many households, especially given the high burden of out-of-pocket medical spending in the country.
