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Changes to tax treatment of medical expenses from 1 March

At present taxpayers aged under 65 years are on a hybrid system with regard to the income tax treatment of their medical expenses. While contributions to medical aids are subject to credit relief, medical expenses in excess of 7.5 % of taxable income are claimed as a deduction. On the other hand, taxpayers aged 65 years or older are on a deduction-only system.

From 1 March 2014, all taxpayers regardless of age will be on a credit-only system. 

As is currently the case, contributions to medical aids or medical expenses by the taxpayer’s employer are a taxable fringe benefit in the hands of the employee but the amount of the fringe benefit is treated as if it was a contribution or expense paid by the employee for purposes of the conversion to credits referred to below.

The main points regarding the workings of the credit-only scheme are as follows. For further clarity we have also provided a worked example.

For taxpayers aged under 65 years without a disabled dependant:

Contribution to a medical aid (without regard to the quantum of the contribution) will qualify the taxpayer to receive a credit of fixed monthly amount, based on the number of the taxpayer’s dependants on the medical aid scheme.

However, to the extent that the sum of:

o  qualifying medical expenses  and

o  medical aid contributions in excess of four times the fixed credit above

exceeds 7.5 % of the taxpayer’s taxable income, an additional credit arises. This additional credit is calculated by multiplying the excess amount by 25%.

For taxpayers aged 65 years and older or for taxpayers with a disabled dependant:

• Contribution to a medical aid (without regard to the quantum of the contribution) will qualify the taxpayer to receive a credit of fixed amount, based on the number of the taxpayer’s dependants on the medical aid scheme.

• However, medical aid contributions in excess of three times the fixed credit amount above will be converted to additional credits at the rate of 33.3%

• Qualifying medical expenses (with no threshold requirement) will also be converted to credits at the rate of 33.3%.

For PAYE purposes the employer may only take the fixed monthly credit amount into account and not the additional credits. Where the employer does not effect payment of the medical aid contributions it may only take the fixed monthly credit amount into account if proof of payment of such contributions has been furnished.

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