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Wagmo
Underwritten by Clear Blue Insurance
Wagmo offers separate wellness and illness plans, with fast reimbursement on wellness claims.
3.8
out of 5
Coverage at a glance
Accident waiting period0 days
Illness waiting period15 days
Orthopedic waiting period15 days
Appeal window60 days
Covers dental illnessYes
Covers hereditary conditionsYes
Covers behavioralNo
Covers exam feesYes
What we like
- ✓Separate wellness plan available
- ✓Fast wellness reimbursement
- ✓No insurance license needed for wellness plans
Watch outs
- ✕Wellness and illness are separate products
- ✕Illness plan more limited
How to appeal a Wagmo denial
Pick the reason on your denial letter to get a reason-specific playbook tuned for Wagmo's policy language and 60-day appeal window.
Insufficient documentation
~75% win rate · low difficulty
Lapsed / inactive policy at time of treatment
~60% win rate · moderate difficulty
Coverage not yet effective / enrollment gap
~55% win rate · moderate difficulty
Curable pre-existing not waited out
~55% win rate · moderate difficulty
Bilateral condition exclusion
~50% win rate · moderate difficulty
Dental illness / dental exclusion
~45% win rate · moderate difficulty
Hereditary / congenital condition exclusion
~45% win rate · moderate difficulty
Not medically necessary / experimental
~45% win rate · moderate difficulty
Out-of-network / non-licensed provider
~45% win rate · moderate difficulty
Specific policy exclusion
~40% win rate · moderate difficulty