Your medical aid said no.
We turn it into a yes.
MediCheck is South Africa's member-first advocacy service. We challenge unfair funding declines, recover the benefits you're legally owed, and stand between you and the paperwork — so you can focus on getting better.
Six services, one mandate: get your claim paid.
We sit on your side of the table. Every member case is run by a senior consultant with hospital, scheme or legal background — not a script.
Claim audits
Line-by-line review of every tariff code, exclusion clause and PMB ruling.
Formal appeals
We draft, lodge and escalate appeals all the way to the Council for Medical Schemes.
Member advocacy
Direct liaison with your scheme so you never have to navigate the call centre alone.
Pre-authorisation
We pre-clear procedures and motivate medical necessity before treatment.
Gap & supplementary
Independent advice on gap cover and hospital cash plans for the holes left behind.
Regulatory recourse
Ombudsman submissions and CMS complaints when schemes refuse to play fair.
A clear path from no to paid.
No jargon, no runaround. A clear path from your first message to a resolved claim.
Join & share
Become a member and securely send us your scheme details and the claim that went wrong.
We investigate
We interpret your benefits against the Act, identify the breach and map the strongest route forward.
We act for you
We draft the motivation or appeal, engage the scheme, and escalate to the CMS where needed.
You get covered
Funding released, money recovered, treatment unlocked — and you're kept informed at every step.
Eight years. Thousands of yes-es.
We measure ourselves in money recovered, not invoices issued. Every figure here is independently audited and reported to our members each quarter.
These recoveries centre on high-value biological cancer drugs.
One infusion can exceed R90 000 and patients need 6–12 cycles. When schemes deny access, we enforce Prescribed Minimum Benefits and appeal on clinical grounds, turning rejections into funded treatment plans.
One reinstated authorisation. R892 875 recovered.
- Medicine
- Enhertu (Trastuzumab Deruxtecan)
- Price per 100 mg vial
- R 22 894.25
- Dose
- 300 mg (3 vials)
- Frequency
- Every 2 weeks
- Duration
- 6 months (13 infusions)
- Cost per infusion
- R 68 682.75
13 infusions × 3 vials × R 22 894.25. Funded via PMB enforcement after an initial scheme decline.
One annual fee. No surprises.
Your Annual Membership Fee (AMF) covers 12 months from your first consultation and is calculated by the number of dependants on your file.
Solo
Just you — no dependants
- Unlimited benefit & PMB queries
- Claim & dispute handling
- One formal appeal included
- WhatsApp support line
Member + 1
You and one dependant
- Everything in Solo
- Cover for 1 dependant
- Priority case handling
- Annual benefit review
Member + 2
You and two dependants
- Everything in Member + 1
- Cover for 2 dependants
- Multiple appeals & CMS escalation
- Dedicated case advocate
Family
You and 3 or more dependants
- Everything in Member + 2
- Cover for the whole household
- Family benefit planning
- Quarterly check-ins
Success Fee. Only when you win.
We charge a graduated success fee based on the amount we recover for you. The more we recover, the lower the percentage — capped so you always keep the majority.
Up to R1,500
R15,000 recovered = R1,125 fee
Of the amount above R20,000. Up to R2,400
R35,000 recovered = R1,950 fee
Of the amount above R50,000. Up to R3,500
R75,000 recovered = R2,950 fee
Maximum fee of R3,500 — no matter how much more we recover
R150,000 recovered = R3,500 fee
Start your application — we'll work out the rest.
Tell us about you and your dependants. Your annual fee is calculated automatically and only billed at your first consultation — no upfront payment to register.
AMF is billed at your consultation and covers 12 months. Payments are processed securely via WalletDoc.
Your Guide to Medical Schemes in South Africa
A plain-language handbook for principal members — covering PMBs, contributions, waiting periods, appeals, fraud and your rights under the Medical Schemes Act. Knowledge is your first line of defence.
Download the free guideKnow your rights, claim with confidence.
Practical, jargon-free articles to help you get the most from your medical scheme.
Medical aid, made watchable.
Short videos breaking down the things schemes would rather you didn't ask about.
Members we've stood up for.
Names and amounts published with member permission. Some details lightly edited for privacy.
"Discovery rejected a R 184 000 hospital bill as 'not clinically necessary'. MediCheck appealed it twice and recovered every cent within nine weeks."
"They speak the schemes' language. Our oncology pre-auth was approved in 48 hours instead of the usual three-week back-and-forth."
"I had given up. MediCheck found a PMB clause I didn't know existed and turned a R 62 000 decline into a full payout."
"My scheme declined a chronic medication twice. MediCheck quoted the exact regulation, appealed, and it was approved within weeks."
"They found an unauthorised debit I hadn't even noticed and recovered every cent. I'd never have spotted it on my own."
"Calm, clear and genuinely on my side. For the first time my medical aid felt like it was working for me, not against me."
Mark Hyman
Founder & CEO, MediCheck
Mark is a healthcare entrepreneur and non-clinical medical schemes advocate with more than four decades across retail pharmacy, primary healthcare delivery and medical scheme benefit interpretation. He pioneered the discounting of prescription medicine in South Africa and built nurse-led clinics inside pharmacies long before it was common.
Today he puts that experience to work for ordinary members — interpreting benefits, contesting declines and helping people access the lawful, clinically appropriate care they're entitled to. He also contributes to public-interest oversight of the industry through several Council for Medical Schemes advisory structures.
Two minutes now can save you thousands later.
Tell us a little about you and your scheme. We'll set up your member file and reach out to confirm next steps.
- Your details are kept private and POPIA-compliant — used only to assist you.
- No obligation — we confirm what we can do before any payment.
- Works with every open and restricted scheme in South Africa.
Talk to us, then pay securely online.
Sit down with an advocate
Pick a time that suits you for a one-on-one virtual consultation. Your session is professionally documented so nothing about your matter gets lost.
Choose a timeConsultations are confidential and documented for accuracy with your consent.
Pay or renew via WalletDoc
Scan the WalletDoc code or tap the button to pay your annual membership securely. Add your membership number as the payment reference so we can match it to your file.
Card details are handled entirely by WalletDoc — we never see or store them.
You pay for your medical aid every month.
Make it pay you back.
Stop facing your medical scheme alone. Cancel any time — no contracts, no exit fees.
Mon–Fri · 08:00–17:00 SAST · Tel: 011 443 1184 · Mob: 084 895 2989 · hello@medicheck.co.za
