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Frequently asked questions

Our 10 most asked questions

MightyWELL is a marketing platform that creates healthcare bundles. These bundles most commonly combine: • Third-party administered benefits (TPA benefits) • ShareWell HealthShare Together, these provide: • Affordable healthcare access • Predictable out-of-pocket costs • Preventive care coverage • Protection against large medical events MightyWELL is not an insurance company.

MightyWELL offers multiple bundle tiers to fit different healthcare needs and budgets. Each tier varies in: • Monthly contribution amount • Unshared amount (similar to a deductible) • Copay amounts for doctor visits • Annual sharing limits • Prescription benefit levels Higher-tier bundles provide lower out-of-pocket costs and broader coverage.

A pre-existing condition is any illness, injury, or medical condition that was diagnosed, treated, or showed symptoms within a specified lookback period before the member's enrollment date. Examples include: • Chronic conditions such as diabetes, heart disease, or asthma • Any condition for which treatment, medication, or medical advice was received • Conditions that showed signs or symptoms, even if not formally diagnosed

Yes. MightyWELL bundles include access to a preferred provider network. • Using in-network providers helps reduce out-of-pocket costs • In-network providers have agreed to negotiated rates • Members can search for providers through the member portal or provider directory • Network availability varies by location

Copays are fixed amounts members pay at the time of service for certain healthcare visits. • Copay amounts vary by bundle tier • Common copay services include primary care visits, specialist visits, and urgent care • Copays are part of the TPA benefits portion of the bundle • The copay amount is the member's only cost for that visit when using in-network providers

In an emergency, members should seek immediate medical attention at the nearest emergency room. • Emergency services are eligible for sharing through the HealthShare • Members should notify the program as soon as reasonably possible after an ER visit • The unshared amount applies before sharing begins • Emergency is defined as a condition that could result in serious harm without immediate treatment

Prescription benefits vary by bundle tier: • Most bundles include some level of prescription drug benefit under TPA benefits • Coverage typically includes generic and preferred brand medications • Specialty medications may have different coverage levels • Members receive a pharmacy card to use at participating pharmacies

Members can enroll through several channels: • Online through the MightyWELL enrollment portal • Through a licensed affiliate or agent • By contacting MightyWELL support directly Enrollment requires completing an application, providing medical history, and selecting a bundle tier.

Monthly contributions are billed automatically: • Members set up automatic payment during enrollment • Payments are processed on a recurring monthly schedule • Credit card, debit card, and ACH bank draft options are available • Members receive a billing statement each month

Members can submit claims through: • The member portal online claim submission form • By mailing required documentation to the claims processing address • By contacting member support for assistance Claim submission requires: • Itemized bill from the healthcare provider • Explanation of services received • Any supporting documentation requested

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