Disclosures

Plan Structure

MightyWELL offers structured health coverage plans designed to provide members with access to comprehensive medical benefits. Our plans include defined copay schedules, preventive care coverage, and major medical protection — all structured to provide clear, predictable benefits.

All benefits are subject to the terms, conditions, and guidelines outlined in your specific plan documents. Plan features including copay amounts, coverage limits, and eligible services may vary by plan tier. Members are encouraged to review their plan documents carefully and contact our team with any questions.

Network Clarification

Network participation applies to streamlined copay and preventive services but is not a limitation on access. Members may use any licensed provider for their healthcare needs.

Using in-network providers allows members to take advantage of negotiated rates and simplified billing through our copay structure. Out-of-network providers are still accessible, and eligible expenses will be processed according to plan guidelines. Members are never restricted to a specific network for receiving care.

Pre-Existing Condition Limitations

Certain pre-existing conditions may be subject to waiting periods before full benefits apply. A pre-existing condition is generally defined as a condition for which you received medical advice, diagnosis, or treatment during a specified period prior to your enrollment date.

The length and terms of any waiting period depend on your specific plan. After the applicable waiting period has passed, pre-existing conditions are eligible for benefits under the same terms as any other covered condition. Please consult your plan documents or speak with a MightyWELL representative for details specific to your situation.

Sharing Structure (ShareWELL)

ShareWELL is MightyWELL's structured sharing component, through which members share in eligible medical expenses. This sharing model is managed and administered by MightyWELL to provide a reliable and organized process for handling larger medical costs.

Members contribute to the sharing pool as part of their membership, and eligible expenses are processed according to established guidelines. ShareWELL operates alongside MightyWELL's direct coverage benefits to provide members with a comprehensive approach to managing healthcare costs.

Benefits Subject to Guidelines

All benefits provided through MightyWELL plans are subject to plan guidelines, eligibility criteria, and the terms described in your membership agreement. Benefits are not guaranteed outside of the specific terms outlined in your plan documents.

Eligibility for specific benefits may depend on factors including plan tier, membership duration, and adherence to plan guidelines such as using designated providers for certain services. MightyWELL reserves the right to modify plan guidelines with appropriate notice to members.

Additional Disclosures

Coverage details, plan availability, and specific benefits may vary by state due to differing regulatory requirements. Not all plans are available in all states, and certain plan features may be modified to comply with local regulations.

MightyWELL plans are not traditional health insurance. They are structured health coverage plans that combine direct benefits with a managed sharing component. Members should review all plan materials carefully to understand how their coverage works.

For questions about plan availability in your state or specific coverage details, please contact our team directly. We are committed to transparency and are happy to walk you through every aspect of your plan.

MightyWELL Health
90 Fort Wade Rd
Ponte Vedra, FL 32081
Email: [email protected]