Does Medical Aid Cover Ostomy Supplies in South Africa?
Quick Answer
How stoma and ostomy supplies are typically funded through South African medical schemes — Prescribed Minimum Benefits, chronic benefits, and scheme-specific stoma care allowances.
Prescribed Minimum Benefits (PMBs)
All registered South African medical schemes must, by law, cover a defined set of Prescribed Minimum Benefits regardless of which plan you hold. Ostomy care following a qualifying procedure (such as bowel cancer surgery) can fall under PMB cover, though the exact pathway depends on your diagnosis and treating specialist's coding.
Scheme-Specific Stoma Care Benefits
Beyond PMBs, several schemes carry a separate, named stoma care allowance as part of their day-to-day or chronic benefits — this is paid out on top of, not instead of, your general medical savings. Because these allowances, limits, and qualifying conditions differ by scheme and by plan option within that scheme, always confirm your specific benefit amount and claim process directly with your scheme before you order.
How to Submit a Claim
Most schemes require a valid ICD-10 diagnosis code from your surgeon or GP together with an itemised tax invoice showing the SAHPRA registration details of the product purchased. G1 Healthcare's invoices include the SKU, UDI code, and SAHPRA registration status needed for a scheme claim — request one at checkout or from your Account > Orders page.
If You Are Not Yet Registered With a Scheme
Every G1 Healthcare product remains available over-the-counter at the listed retail price, medical aid or not — you are never required to have scheme cover to order. Cash and card payment via PayFast is available on every order.
This article is for general educational purposes and does not replace advice from your stoma care nurse, surgeon, or physician. Always consult a qualified healthcare professional about your specific care needs.