Plan your next order
Medical aid stoma allowance & co-payment calculator
Work out what your next ostomy supply order costs in South African rand. Compare care bundles, enter the benefit confirmed by your medical scheme and prepare a quotation before you buy. G1 takes payment at checkout; this tool does not arrange direct scheme billing.
Plan your supplies and pay-and-claim costs
Choose your supplies, see the full payment due to G1, then estimate what your medical aid might reimburse after you submit your invoice.
Estimate, not an authorisation. The named-plan presets below are illustrative scenarios supplied for this tool, not published 2026 scheme limits. Replace them with your scheme-confirmed remaining allowance and reimbursement percentage. A zero result does not mean an approved claim.
2 boxes · 40 pouches
G-1 Health Care One-Piece Open Ostomy Bag 70mm (Box of 20)
*Arithmetic at 30 pouches/month, not safe wear time or clinical advice. Follow your nurse’s individual change schedule.
Pay G1 in full, then claim
1. Pay the full order total at checkout. 2. Keep your itemised invoice and payment confirmation. 3. Submit these to your medical aid with its required documents. Reimbursement is paid by your scheme if your claim is approved.
Modelled monthly allowance: R 0,00. Unused modelled budget: R 0,00. Other claims and benefit restrictions may reduce this amount.
Save R 399,00 against 2 current single boxes.
Selling prices shown in ZAR. VAT status has not been confirmed; no separate VAT or tax-invoice entitlement is represented.
How much fits with no modelled shortfall?
0 boxes · 0 pouches within your entered budget, reimbursement rate and current delivery rule.
Checks orders of 1–6 boxes. No order in this range has a zero estimated personal cost.
Same quantity, your comparison
Example personal cost: R 3 800,00
G1 estimated personal cost: R 2 099,00. Modelled personal-cost difference: R 20 412,00 over 12 identical monthly orders. Product suitability and scheme tariffs can differ.
Your claim checklist
- SAHPRA establishment licence
- 00005410MD
- CIPC
- 2025/451756/07
- Product SKU
- G1-OST-70MM
- ICD-10 reference for clinician review
- Z43.3 · Attention to colostomy; Z93.3 (status)
- Pathway
- Quotation for assessment, or pay and claim if your scheme authorises reimbursement.
The order action adds these supplies to your existing basket; final checkout includes all basket items. Scheme/type drafts stay in memory and can be reviewed before submission. No calculator input is sent until you order or submit a quotation.
Before you submit a medical-aid claim
Ask your scheme about remaining limits, the reference tariff for your exact product, designated suppliers and authorisation. Do not interpret a plan name or PMB status as an automatic monthly rand allowance.
Read GEMS appliance guidance and Discovery’s 2026 Comprehensive plan guide, then confirm your own plan’s current rules through its official member channel.
Medical-aid calculator questions
How many ostomy bags does medical aid cover per month?
There is no universal pouch count. Ask your scheme for your remaining stoma benefit, applicable reference tariff, approved quantities, designated supplier and authorisation requirements. This calculator models the figures you enter; it does not confirm cover.
Can I estimate a Discovery Health ostomy bag co-payment?
Yes. Enter the allowance and reimbursement percentage confirmed by your plan. The calculator subtracts the lower of your entered budget and percentage of the G1 supply price from the order total. Preset scenarios are illustrative, not Discovery benefit quotations.
Does a zero estimated shortfall guarantee medical-aid payment?
No. The estimate assumes the entered reimbursement percentage applies to the full G1 supply price. Scheme reference tariffs, eligibility, designated suppliers, other claims and authorisation can change the amount paid. G1 checkout takes payment; reimbursement must be arranged with your scheme.
Can I download a quotation before buying?
Yes. Download a private pro-forma quotation with live catalogue prices and your scheme details for assessment. A clinician must confirm any ICD-10 code. The quotation is not proof of authorisation or a paid tax invoice.