Guide on the Determination of Medical Tax Credits – June 2026 update, SARS – Part four – Annexure B – The prescribed list of expenditure

This is article four discussing the updated Medical Tax Credits Guide, Issue 18, of June 2026. Please read the previous articles before proceeding with this article, which lists relevant information on prescribed lists of expenditure (Annexure B of the Income Tax Act 58 of 1962).

The prescribed list of expenditure based on paragraph (c) of the definition of “qualifying medical expenses” in section 6B(1) of the Act is described below:

NATURE OF EXPENSE

A. PERSONAL CARE ATTENDANT EXPENSES

Expenditure prescribed by the Commissioner under this category is as follows:

1. A salary paid to a person who is employed solely to care and look after the needs of a person with a disability.

Note: If the person is employed on a full-time basis to perform housekeeping activities, the salary paid to such person will not qualify.

2. Living-in expenses for a live-in personal care attendant, which are limited to the additional cost of electricity, water and food as a result of a live-in personal care attendant, are deemed to be 20% of the “national minimum wage” as defined in the National Minimum Wage Act 9 of 2018.
3. If more than one live-in personal care attendant is employed on a full-time basis at the same time, the amount which can be claimed may not exceed 20% (per personal care attendant) of the “national minimum wage” as defined in the National Minimum Wage Act 9 of 2018.

Note: A “spouse” as defined in section 1(1) of the Act and your or your spouse’s parents’ or grandparents’ are not regarded as personal care attendants for the purposes of this list.

If the live-in personal care attendants alternate days, the living expenses are limited to one live-in personal care attendant.

4. Cost of training a personal care attendant or a family member to take care of a person with a disability. This refers to relevant courses or training undergone by a personal care attendant or family member who will care for a person with a disability. The cost must be paid to a service provider that is in the business of providing such training.
5. Accommodation expenses paid for a personal care attendant for the purposes of training under A4 above or for business and holiday travel of the person with a disability.
6. Accommodation expenses for the purposes of training referred to under A4 for a family member.

B. TRAVEL AND TRANSPORTATION

Expenditure prescribed by the Commissioner under this category is as follows:

1. Travelling expenses incurred and paid by the taxpayer to acquire qualifying goods or services under this list, including the maintenance of such goods.
2. Travelling expenses incurred and paid by the taxpayer for the purposes of training as contemplated under A4 of this list.
3. Transportation costs specifically incurred and paid in respect of a learner with a disability who attends a special education needs school or a mainstream school that caters to a child with a disability (under the circumstances referred to in F7 and F8) in instances where such a school is not available within a 10 km radius from where the person lives.

Please note that only the transportation costs in respect of kilometres exceeding the 10 km radius can be claimed.

4. Transportation costs incurred and paid to transport a person with a disability from home to a protective workshop, if the following conditions are met:

• The person must, due to the nature of his or her disability, have no reasonable prospect of finding employment in the open labour market.
• The person must need daily care and supervision.
• The person must be a “child” as contemplated in section 6B(1) of the Act who has a “disability” as defined in section 6B(1) of the Act.
• The protective workshop must be a public benefit organisation-approved workshop by SARS under section 30(3) of the act.

Note: For purposes of this list, a crèche will not qualify as a protective workshop.

5. Transportation costs incurred and paid in respect of a personal care attendant while away from the primary residence of a person with a disability. For example, if the person with a disability is going away on business or on holiday accompanied by a personal care attendant, the actual cost of travel by air, train, bus or taxi, in respect of the personal care attendant, will be deductible.

Note: Where a taxpayer has used a private motor vehicle for transportation other than that which is listed under B5 and accurate records of qualifying kilometres are kept, SARS will accept the estimate of the expenses incurred by using the rate per kilometre prescribed by the minister of finance under paragraph 4 of the Income Tax Regulations titled “Fixing of Rate per Kilometre in Respect of Motor Vehicles”.

• Travelling must be to the nearest place where the goods or services can be acquired, serviced or repaired.
• Transportation costs incurred and paid in respect of transporting care attendants from home to work or vice versa do not qualify.
• Where you are using your own transport, for example, your car, plane, boat, etc., no expenses will be allowable in respect of B5.

C. INSURANCE, MAINTENANCE, REPAIRS AND SUPPLIES

Expenditure prescribed by the commissioner under this category is the following:

Insurance, maintenance, repairs and supplies (including batteries) only in respect of qualifying goods that fall under this list.

Note: The qualifying goods insured must be specified in the insurance policy.

D. PROSTHETICS

Expenditure prescribed by the commissioner under this category is the following:

Cost of prosthetic limbs (including custom-made braces for limbs and woven or elasticised stockings).

E. AIDS & OTHER DEVICES

Expenditure prescribed by the Commissioner under this category is as follows:

1. 50% of the cost of an air conditioner, heater, fan, and environment control system (computerised or electronic) to prevent hypothermia or hyperthermia for a person with a spinal cord injury (termed a paraplegic, quadriplegic or tetraplegic).
2. Computer devices and related equipment (for example, a trackball), including the software to operate such devices, required by a person with a disability due to a moderate to severe impairment in hand function or visual ability.
3. Cell phone applications required by a person with a disability due to a moderate to severe impairment in visual or hearing ability (note that this excludes the actual cost of the cell phone).
4. Computer software or other electronic equipment required in order to convert printed material or image files into text, Braille, speech or any other accessible format, including peripheral equipment such as scanners and Braille printers.
5. Converted, printed and graphical material, including talking, Braille and large print textbooks and maps or drawings for a person with a disability.
6. Helmets (protective gear) are used by persons with epilepsy to prevent injury, especially head injuries during seizures.
7. Home assistive tools (without which performing a task would not be possible) that enable a person with a disability to perform tasks of daily living.

Examples:

• Utensil hand-clip eating aid for persons who struggle to grasp and hold small utensils and reaching aids that assist a person to grasp hard-to-reach items more easily.
• Adhesive bump dots used to differentiate settings on, for example, home appliances like an oven.

8. Magnification and image-enhancement devices that enable a person to read, such as optacons, large-screen computer monitors, magnifiers, video magnifiers, CCTV readers, video goggles, electronic magnifiers (that plug into a computer, monitor or TV) and telescopic spectacles.
9. Mobile ramps and tie-downs used to assist wheelchair users to move in and out of vehicles or buildings that have no ramps.
10. Mobility aids, including wheelchairs, wheelchair carriers, crutches and walking frames.
11. Bathroom aids to help a person in or out of a bath or shower or to get on or off a toilet.
12. Navigation aids, including white canes, sonic or obstacle-learning (echolocation) devices and hand-held talking GPS devices and related software, are required by a person with a moderate to severe visual impairment.
13. Orthopaedic shoes, boots and inserts, including braces, as well as standard shoes and boots used by a person who walks with an unsteady gait when not using such aid.
14. Page-turning devices used to assist a person to turn the pages of a book or other bound document where the disability moderately or severely restricts their ability to use arms or hands.
15. Prescription spectacles and contact lenses will qualify to the extent that these amounts have not been recovered from a medical scheme.
16. Pressure care mattresses and body positioners to prevent pressure sores and correct postural alignment for persons with a spinal cord injury.
17. Signalling devices – emit light instead of sound (for example, light-emitting doorbells).
18. Amplification, loop systems specifically designed to assist hearing, and other assistive listening devices to be used by a person who has a hearing impairment (including related accessories).
19. Money templates used to differentiate between various denominations of notes and coins.
20. Speech-generating devices and communication boards that enable a person to communicate, including a relevant keyboard for a person with a moderate to severe speech impairment. Specialised anti-glare and flicker-free screens – for televisions and computers used by a person with photosensitive epilepsy to minimise exposure to seizures. This includes laryngectomy speaking valves and accessories.
21. Talking, sound-making and vibrating devices that enable a person to perform daily tasks. For example, talking calculators, adapted watches and clocks, shake-awake alarms, talking kitchen scales, light detectors, liquid level indicators, etc.
22. Seizure alert devices (for example, mattress sensor alarms, watch devices, anti-suffocation pillows, and seizure alert cameras), excluding standard camera devices.
23. Teletypewriters or similar devices required by a person with a hearing impairment to make or receive phone calls where the impairment is moderate to severe.
24. Television closed-caption decoders or readers are required by a person with a moderate to severe hearing or visual impairment.
25. Word-to-text devices – for a person with a disability that causes a moderate-to-severe impairment in hand functions or visual or hearing impairments as experienced by some persons with cerebral palsy.
26. Toilet seats, bath seats, shower seats or commode chairs specially designed for use by persons with a physical disability.
27. Lifts to move persons with physical disabilities.
28. Grab rails or hoist placed in such a way as to aid a person with a physical disability.
29. Stair chairs specifically installed to aid a person with a physical disability.

Note: The cost of electricity needed to operate these devices will not be a qualifying expense.

F. SERVICES

Expenditure prescribed by the Commissioner under this category is as follows:

1. Deaf-blind intervening services.
2. Lip-speaker services.
3. Note-taking services, including real-time captioning.
4. Reading and navigation services.
5. Rehabilitative therapy to teach a person to function or perform basic daily activities (for example, how to use a wheelchair, dress, groom, etc.).
6. Sign-language interpretation services used by a person with a hearing impairment.
7. Special education schools for learners with disabilities. Qualifying expenses will include:

• school assistant or classroom costs; and
• school fees limited to the amount in excess of the fees that would have been payable if the person attended the closest fee-paying public school not specialising in learners with special educational needs.

1. School not specialising in learners with special educational needs is limited to additional expenses incurred and paid as a result of the disability.
2. Tutoring services used by a person with a disability, which are supplementary to the primary education of a person with a learning disability or impairment in intellectual or mental functions and paid to someone in the business of providing such services.
3. Specialised training services for a person with a disability – this category includes expenditure incurred and paid for specialised training provided to a person with a disability for rehabilitation purposes. This will include training to cope with the disability, how to use an assistive device or aid, etc.
4. Motor vehicle driving services for a person with a disability.
5. The cost of adjustments to clothing in order to ensure ease of dressing.

Note: Only services that are acquired from an independent service provider, who is not a “connected person” (as defined in section 1(1) of the Act) in relation to the taxpayer (unless the spouse or family member is in the business of providing such service), will qualify.

G. CONTINENCE PRODUCTS

Expenditure prescribed by the Commissioner under this category is as follows:

1. Catheters, catheter trays, tubing and associated products required for catheter use, as a concomitant to the disability.
2. Colostomy, urostomy, ileostomy and colostomy products and associated products and aids as a concomitant to the disability.
3. Nappies, disposable briefs, pads, linen and mattress savers used by a person for the management of continence as a concomitant to the disability.
4. Anal-irrigation kits (in respect of bowel management).
5. Disposable examination gloves or disposable sterile gloves used by a person in the management of continence as a concomitant to the disability. Washable undergarments and other washable accessories used by a person in the management of continence as a concomitant to the disability.

H. SERVICE ANIMALS

Expenditure prescribed by the Commissioner under this category is as follows:

1. The cost of an animal specifically trained to be used as an aid to perform daily functions.
2. The care and maintenance (including food and veterinary care) of such an animal.

I. ALTERATIONS OR MODIFICATIONS TO ASSETS ACQUIRED OR TO BE ACQUIRED

Expenditure prescribed by the commissioner under this category is the cost of the following:

1. Buying and installing outdoor ramps to a person’s residence where a stairway impedes the person’s mobility with a physical disability.
2. Enlarging passageways, bathrooms and doorways to give the person wheelchair access to the various rooms of the residence.
3. Lowering existing kitchen or bathroom cabinets to give the person with a disability access to them.
4. Auxiliary driving controls to a motor vehicle that enable a person with a disability to operate the motor vehicle.
5. Modifying a motor vehicle to adapt it for transporting persons with a physical disability.
6. If you received the International Trade Administration Commission (ITAC) rebate on the fully imported modified motor vehicle, then no modification cost can be claimed. If you did not receive the ITAC rebate, only the ascertainable costs in respect of the modification of the motor vehicle are a qualifying expense under this list.

Note: If the vehicle is imported unmodified and modified only in South Africa, the taxpayer can claim the cost of the modification less the rebate.

7. Alarm systems – modifications to an alarm system to enable a person with a disability to use or operate it. For example, modifications to the alarm system to emit a red light instead of making a sound (used to warn a person with a hearing impairment that the alarm has been activated) will qualify.
8. The cost of automating doors and gates for a person with a physical disability.

Note: Renovation and construction expenses covered under I1 to I3 must be reasonable and meet the following conditions:

 They would not typically increase the value of the asset.
 They would not typically be incurred by persons who do not have a moderate to severe mobility impairment.

Expenses are more likely to be considered reasonable if the materials used are similar to existing materials.

9. An amount paid by a taxpayer, who is a parent of a child with a physical disability, to make the school accessible to the child, for example, building a ramp (which the school could not afford to do). However, should the school issue a section 18A donation receipt in this regard, the amount will not be a qualifying disability expense under this list. The amount, for which the receipt was issued, can be claimed as a deduction against taxable income under the provisions of section 18A of the Act.