JHB 
With South Africa’s tax filing season underway, one area that consistently raises questions is the ability to claim additional medical expenses from SARS. For many individuals and families, medical aid contributions only partially cover the true cost of healthcare. Out-of-pocket expenses for consultations, procedures, or specialist treatments can quickly add up, leaving taxpayers wondering whether these costs can reduce their tax liability.
The Income Tax Act (section 6B) provides for an Additional Medical Expenses Tax Credit (AMTC). While valuable, it is a complex relief mechanism that requires careful substantiation and record-keeping. Misunderstanding the rules or submitting incomplete claims can easily lead to SARS rejecting your submission.
What qualifies as additional medical expenses?
The AMTC covers a wide range of qualifying medical costs, provided they meet two criteria:
They are paid to a registered healthcare provider such as doctors, dentists, physiotherapists, pharmacists, or hospitals.
They are out-of-pocket expenses, meaning costs not recoverable from your medical aid or another party.
This definition extends beyond general healthcare to include costs associated with a disability or mental impairment, provided that the necessary medical practitioner’s confirmation (via the ITR-DD form) is supplied to SARS. Dependants, such as a spouse, child, or another supported family member, are also included in the scope of claimable expenses.
The importance of proper documentation
One of the most common pitfalls for taxpayers is underestimating the burden of proof. SARS requires supporting documents for every claim, including:
Medical aid tax certificates
Invoices and receipts from healthcare providers
Schedules detailing unreimbursed costs
Completed ITR-DD forms for disability-related expenses
These documents must be retained for at least five years under the Tax Administration Act. Without proper records, even legitimate expenses may be disallowed.
How SARS calculates the credit
Claiming additional medical expenses is not a straightforward “rand-for-rand” deduction. The AMTC is calculated based on income level, age, disability status, and the proportion of out-of-pocket costs relative to taxable income.
In most cases, relief is limited to expenses and contributions that exceed 7.5% of taxable income, and only 25% of that excess can be claimed as a credit. For taxpayers with dependants who are elderly or disabled, SARS applies more favourable rules, which may significantly increase the allowable credit.
Simply put, lower-income taxpayers who incur relatively higher medical costs often receive a larger benefit than higher-income taxpayers with the same expenses.
Why professional guidance matters
The intricacy of SARS rules, the requirement for rigorous documentation, and the nuanced calculation methodology make this an area where professional tax advice adds real value. Attempting to navigate the AMTC without expertise often results in under-claiming, over-claiming, or outright rejection of your tax return.
By partnering with a tax professional, you ensure:
Claims are accurately calculated against SARS thresholds
Your filing is compliant, reducing the risk of penalties or audits
Final thoughts
Medical costs are a financial burden that many South Africans shoulder each year. While the SARS Additional Medical Expenses Tax Credit provides relief, accessing it requires knowledge, diligence, and a proactive approach to record-keeping.
At MMS Group, our tax specialists help our clients to navigate this complexity to secure the relief they are entitled to. If you have incurred significant out-of-pocket medical costs and want to maximise your tax benefit, reach out to our team to simplify the process and ensure your compliance with SARS requirements.