Memorandum on Frequently Asked
Questions.

To access the full-stack Gabriel experience, you enroll and manage your coverage through Gabriel. That is what lets us coordinate the plan, help manage benefits, support care navigation, and apply wellness benefits in one member experience. See full coverage scope →

You can also pay annually (two months free on Emerald, three on Sapphire). Qualifying wellness purchases may be HSA/FSA-eligible at the point of use. Compare tiers →

Every category is covered on every tier. The only thing that changes between Emerald / Sapphire / Onyx is the monthly dollar ceiling on those categories — $600, $1,000, and $5,000 respectively. See all 8 categories →

We use the PHCS national PPO network for conventional care — 1.2 million providers, every major hospital system. You don't need referrals for specialists on Sapphire or Onyx.

We'll tell you straight during enrollment if we're not the right fit. We don't sell memberships we can't honor.

If you're switching from another health plan, we time the transition so you're never uncovered. Tell us your current plan's end date and we handle the overlap.

In some cases that may mean switching plans. In other cases it may mean enrolling in a similar plan through Gabriel so we can manage the experience properly. The policy is still distinct from the Gabriel Care membership layer; Gabriel is the platform that coordinates and supports it.

Gabriel helps keep itemized receipts organized for qualifying provider purchases. Tax advice is yours, and members should confirm eligibility with their HSA/FSA administrator or tax advisor.

The only time this matters: certain concierge practices charge "retainer" fees that healthshare doesn't cover. You can still pay for those out of pocket, we just can't reimburse the retainer itself.

Our Sapphire tier averages $4,600/year less than MDVIP once you net out coverage. See how one member compared →

Onyx families get a dedicated family coordinator who manages all household appointments, school forms, and specialist referrals for everyone under one roof.

If the ER is out-of-network, we cover anyway — there's a special provision for emergencies. Post-emergency, your Gabriel coordinator follows up within 24 hours to make sure discharge planning is handled.

If we're going to deny something, we tell you within 4 hours, explain why, and offer alternatives. No silent denials.

Denial rate in year one: under 3%. Most of those were fraud attempts or clear out-of-scope requests (cosmetic procedures, experimental treatments without protocol). Legitimate appeals are overturned about 70% of the time.

Onyx members get full international coverage including routine care, evacuation insurance, and a concierge who speaks five languages. If you break your leg in Lisbon, they're handling the logistics before you're off the tarmac.

For complex conditions, Sapphire and Onyx members get access to our Medical Advisory Board — four physicians (two conventional, two integrative) who review the case and offer a second opinion at no cost.

Our Medical Director oversees the psychedelic program personally. Every covered provider is board-reviewed and screened for clinical protocol adherence.

We are SOC 2 Type II and HIPAA compliant. Annual third-party audits are published to members on request. We've never had a breach; if we did, we'd tell every affected member within 48 hours, not wait out the legal minimum.

If you're in a state we don't yet serve, you can join our waitlist and we'll notify you the day we launch locally. See full state map →

About 6% of members cancel in their first year. Of those, about a third come back within six months. We'd rather you leave easily than stay unhappily.

Every month, we publish a transparency report: how much came in, how much paid claims, how much overhead. You can read every report at /transparency once you're a member.

We keep a running log of every question we get. If enough members ask the same new one, it shows up in the next revision of this memo. This document is version 2.3.