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Financial Support for Neurodivergent Individuals in South Africa: A Step-by-Step Guide

  • Jul 28
  • 6 min read
Guide on financial support for neurodivergents in South Africa, detailing PMB, SARS Tax Benefits, SASSA Care and Disability Grants.

Living as a neurodivergent person in South Africa comes with unique challenges — emotionally, socially, and financially. Whether you’re navigating the costs of therapy, assessments, medication, assistive devices, or educational support, it’s important to know that you are not alone — and that financial help is available.


This neuro-affirming guide breaks down the key forms of support available, including medical aid PMB coverage, SARS tax benefits, and grants from SASSA — with clear steps on how to qualify and apply.


Understanding Neurodivergent Financial Support in South Africa


Neurodivergence includes a wide range of neurological variations like Autism, ADHD, Dyslexia, Tourette’s, Epilepsy, and other cognitive or developmental differences. These are not “disorders to fix” — they are valid ways of existing and thinking.


But the reality is, neurodivergent people often face increased costs: therapy, support services, specialized education, or even daily care. That’s where financial support systems come in.


Discover financial support for neurodivergent individuals in South Africa with our step-by-step guide.


1. Prescribed Minimum Benefits (PMBs) from Medical Aids


Medical Aids in South Africa are legally required to cover Prescribed Minimum Benefits (PMBs) for certain conditions — including some neurodivergent-related diagnoses or co-occurring psychiatric conditions. PMBs are defined by law through the Medical Schemes Act of 1998 and are meant to guarantee access to essential care. However, the list of conditions covered under the Chronic Disease List (CDL) does not currently include ADHD, Autism, Sensory Processing challenges, or Anxiety disorders.


✅ Conditions that are covered under PMBs:


  • Epilepsy: Specifically status epilepticus and initial diagnosis/neurosurgery cases are included under the PMB Brain & Nervous System list (e.g. PMB code 902A), and must be covered by all medical schemes.

  • Severe neurological conditions resulting in non‑progressive disability (e.g. cerebral palsy, severe developmental delays affecting breathing/eating/speech) may fall under PMB diagnostic-treatment pairs such as ICD-10 code 213A for difficulty in breathing/eating/swallowing due to neurological impairment.

  • Schizophrenia (DTP code 907T) - chronic condition included on the Chronic Disease List (CDL); hospital-based management up to 3 weeks per year plus ongoing medication and consulting care.

  • Bipolar Mood Disorder - also included on the CDL; schemes must pay for medication and care under PMB regulations.

  • Major Depression - Medical schemes in South Africa are legally required to provide coverage for “major affective disorders, including unipolar and bipolar depression”, under PMB code 902T. It includes Hospital-based care: Up to 3 weeks per year, and Outpatient psychotherapy: Up to 15 consultations per year.

  • Developmental delays (depending on severity and diagnosis)

  • Attempted suicide - treated as a PMB emergency; coverage includes 3 days in hospital or 6 outpatient psychiatric/psychological contacts per event (no annual cap on attempts).

  • Acute stress disorder (following trauma) - Hospital admission up to 3 days OR up to 12 outpatient psychotherapy contacts.


❌ Conditions that are not covered under PMBs:


  • Autism Spectrum Disorder (ASD) is not listed as a PMB or Chronic Disease List condition. Costs for diagnosis, therapy, and interventions are subject to the specific rules and limits of your medical scheme.

  • ADHD is explicitly not regarded as a PMB condition; funding is inconsistent across schemes and often limited or non-standardized. Coverage—if offered—depends on your specific plan as a non‑PMB benefit. Many schemes place ADHD on an Additional Disease List (ADL) instead; it’s not guaranteed under PMB rules.

  • Other neurodivergent-related conditions like sensory processing disorder, anxiety, dyslexia, speech or language delays are also not on the official PMB list and typically require funding via your plan’s day-to-day benefit or specialized network providers.


If you have ASD or ADHD: Look into whether your plan includes ADHD or ASD under chronic or ADL benefits—but don't assume PMB applies. If it isn’t covered, reach out to your scheme for options or consider higher-tier plans that may include these conditions in supplementary benefits. Some medical aids include ADHD or ASD coverage on select options—usually under chronic or non-CDL (Chronic Disease List) categories, meaning coverage is optional and plan‑dependent.


📝 How to Check Your Medical Aid Scheme's PMB Rules:


  1. Visit the Council for Medical Schemes PMB Conditions Page

    You can download the full list of 270 PMB diagnoses and 27 Chronic Disease List (CDL) conditions directly from the CMS website—annexure A includes ICD‑10 codes and treatment pairs. Download the PMB Conditions List here.

  2. Review Your Scheme’s PMB Schedule or Member Guide

    For example, Discovery Health publishes a PDF listing the current PMB codes and descriptions, including neurological diagnoses like epilepsy, stroke, infections of the CNS, etc. 

  3. Contact Your Medical Aid Provider or DSP

    Ask explicitly: “Which neurodevelopmental or neurological conditions do you cover under PMB? Do you fund ASD, ADHD, or speech/OT therapy under PMB or supplementary benefits?”

  4. Obtain a “PMB motivation letter” from your treating clinician

    It must include the ICD‑10 code, clinical diagnosis, required treatment plan, and reference that the condition aligns with PMB definitions under CMS guidelines.

  5. Submit to your scheme with the PMB request

    If denied, appeal via the Council for Medical Schemes—they enforce these mandates fairly strictly for listed PMBs.


👉 Some therapies like occupational therapy, speech therapy, or psychiatric care may be covered in full or partially under PMBs.


2. SARS Disability Tax Benefits


SARS offers tax deductions for people with disabilities or who have a neurodivergent dependent.


🧠 What qualifies as a "Disability" for tax purposes?

According to SARS, a “disability” is a moderate to severe impairment that lasts more than a year and substantially limits daily functioning.


This may include:

  • Autism

  • ADHD (in moderate-severe cases)

  • Epilepsy

  • Cognitive or learning disabilities

  • Physical impairments

  • Mental health conditions like chronic depression or bipolar disorder


📑 Documents Needed:

  • ITR-DD Form completed by a registered medical professional (updated every 5 years).

  • Receipts for all related medical expenses not covered by medical aid.

  • Proof of diagnosis.


💼 What Can You Claim?

  • Therapy (speech, OT, psychology)

  • Special needs education

  • Medication

  • Assistive devices

  • Transport to and from therapy (in some cases)

  • Home modifications


🧾 How to Apply:

  1. Download the ITR-DD form from the SARS website.

  2. Get your healthcare provider to complete and sign it.

  3. Submit it with your annual tax return via SARS eFiling.

  4. Keep receipts and supporting docs for up to 5 years.



3. SASSA Disability and Care Dependency Grants


A. Care Dependency Grant (for children under 18)

This grant is for parents or caregivers of children with severe mental or physical disabilities who need full-time care.


💰 Amount: R2,180 per month (as of 2025)

✔️ Who Qualifies:

  • South African citizen or permanent resident

  • Child under 18 with severe disability

  • Medical assessment confirming need for care

  • Income below the means test threshold



B. Disability Grant (for adults over 18)

This is for adults who cannot work due to a mental, cognitive, or physical disability.


💰 Amount: R2,315 per month (as of 2025)

✔️ Who Qualifies:

  • South African citizen or legal resident

  • Between 18 and 59 years old

  • Medical report confirming permanent or temporary disability

  • Income and asset limits apply


📝 How to Apply:

  1. Visit your nearest SASSA office or mobile outreach.

  2. Take your ID, proof of income, medical records, and proof of residence.

  3. Get a medical assessment done by a SASSA-appointed doctor.

  4. Wait 2–3 months for approval (backpay applies from application date).



While the Disability Grant isn’t neurodivergent-specific, individuals with permanent cognitive or mental conditions (e.g. severe Autism, ADHD, psychiatric disabilities) that impair daily functioning may qualify under SASSA’s medical criteria.


4. Tips to Make the Process Easier


  • Neuro-affirming support letters from therapists or psychologists can strengthen your applications.

  • If your child is homeschooled due to their neurodivergence, mention it in your SARS or SASSA documents.

  • Keep copies of all forms, emails, and receipts.

  • Connect with support groups (like The Neuroverse South Africa, Autism South Africa, ADH Support Group of South Africa).

  • If you are denied benefits, appeal the decision — many denials are reversed after reassessment.


Support is a Right, Not a Privilege


Being neurodivergent is not a flaw — and accessing financial support doesn’t make you a burden. You are deserving of help, care, and dignity. These systems exist to reduce barriers — not to shame you for needing support.


You are not alone on this journey — and you are worthy of every resource available to help you thrive.


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