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Can you get the section 6B tax credit for medical expenses paid for a ‘cosmetic’ operation?

Wednesday, 12 August 2015   (0 Comments)
Posted by: Author: SAIT Technical
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Author: SAIT Technical

Q: I have a client who underwent a procedure for which the medical aid scheme did not pay. It was a full ‘out-of-pocket’ procedure. According to the ICD10 code, it might have been an operation of a cosmetic nature of the stomach. That might be the reason for the medical aid not paying. 

According to the definition, any procedure or service rendered by a medical professional can be claimed for tax purposes. Would this then be allowed as a deduction for her 2015 return? 

Could you please advise me about the deductibility of the expense?

A: The issue is whether or not it is qualifying medical expenses as defined in section 6B.  We accept that, if she was a member of a medical scheme it may not have been covered, because cosmetic surgery is elective and for that reason not usually covered by medical schemes.  It may also not qualify as a "relevant health service” in terms of the definition in the Medical Schemes Act, 1998.  The Income Tax Act, however, doesn’t refer to this. 

The section 6B(1)(a)(i) requirement is that it must be "amounts … paid by the person … to any duly registered medical practitioner, dentist, optometrist, homeopath, naturopath, osteopath, herbalist, physiotherapist, chiropractor or orthopaedist for professional services rendered or medicines supplied to the taxpayer…”  The subsection doesn’t, as with nursing or a nurse (in item (ii)), refer to illness or confinement.  The item (i) expenses are also not further qualified as is for instance expenses in consequence of any physical impairment or disability suffered by the taxpayer – there the expenses must be prescribed by SARS. 

The only requirements then seem to be that it is paid to a duly registered person (mentioned in the section) and that it must be for professional services rendered.  We submit that duly registered refers to registered with the Health Professions Council of South Africa – see SARS’s guide on the determination of medical tax credits and allowances.   

No guidance is given on the meaning of professional services rendered and the phrase must take its ordinary meaning.  The Health Professions Act, 1974, refers to a person practicing "any health profession the practice of which mainly consists of -

(i)                              the physical or mental examination of persons;

(ii)                            the diagnosis, treatment or prevention of physical or mental defects, illnesses or deficiencies in man humankind;

(iii)                           the giving of advice in regard to such defects, illnesses or deficiencies; or

(iv)                          the prescribing or providing of medicine in connection with such defects, illnesses or deficiencies…”

As the taxpayer would bear the onus of proof if the claim is disputed (it could well be that SARS’s view may be that it is not qualifying medical expenses) it is suggested that you provide the client with a tax opinion or obtain one from SARS. 

Disclaimer: Nothing in this query and answer should be construed as constituting tax advice or a tax opinion. An expert should be consulted for advice based on the facts and circumstances of each transaction/case. Even though great care has been taken to ensure the accuracy of the answer, SAIT do not accept any responsibility for consequences of decisions taken based on this query and answer. It remains your own responsibility to consult the relevant primary resources when taking a decision. 



Section 240A of the Tax Administration Act, 2011 (as amended) requires that all tax practitioners register with a recognized controlling body before 1 July 2013. It is a criminal offense to not register with both a recognized controlling body and SARS.

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