Disclaimers

Last updated: February 11, 2026

1. Not Medical Advice

BenefitGuard is an informational tool about health insurance, not health care. We do not:

• Diagnose medical conditions or symptoms
• Recommend medical treatments, procedures, or medications
• Provide clinical opinions or second opinions on medical decisions
• Replace the advice of physicians, nurses, or other healthcare professionals
• Determine whether a medical procedure is medically necessary

If you have questions about your health or a medical condition, consult a licensed healthcare provider. If a response from BenefitGuard discusses a medical topic, it is only in the context of how insurance coverage may apply — not as clinical guidance.

2. Not Legal Advice

BenefitGuard provides information about healthcare laws and regulations (such as the No Surprises Act, the Affordable Care Act, HIPAA, ERISA, and state insurance laws) for educational purposes. We do not:

• Provide legal advice or legal representation
• Create an attorney-client relationship
• Guarantee specific legal outcomes for your situation
• Replace consultation with a licensed attorney
• Interpret how specific laws apply to your individual circumstances

Laws vary by state and change over time. The information in our knowledge base reflects our understanding as of the date it was last updated, but may not reflect the most current legal developments. If you need legal advice about a denied claim, a billing dispute, or your rights under any law, consult a licensed attorney or your state's Department of Insurance.

3. Not Financial or Insurance Advice

BenefitGuard does not:

• Recommend specific insurance plans, policies, or coverage levels
• Advise on whether to accept or reject a settlement or payment plan
• Provide tax advice regarding medical expenses or Health Savings Accounts
• Act as an insurance broker, agent, or adjuster
• Determine your out-of-pocket costs with certainty

Cost estimates, coverage interpretations, and benefit summaries provided by BenefitGuard are based on the documents you upload and our AI's interpretation of them. These are approximations only. Your actual costs and coverage depend on your specific plan terms, your insurer's determinations, and the specific circumstances of your care. Always contact your insurance company directly to confirm coverage and costs before making financial decisions.

4. AI Limitations

BenefitGuard uses artificial intelligence (OpenAI GPT-4o) to generate responses. While we strive for accuracy, AI technology has inherent limitations:

• Responses may be inaccurate: AI can misinterpret questions, misread document content, or generate plausible-sounding but incorrect information (“hallucinations”)
• Knowledge may be outdated: Our AI's training data has a cutoff date, and insurance regulations, plan terms, and provider networks change frequently
• Context is limited: The AI only sees excerpts from your documents (not the full text) and may miss important details that appear elsewhere in your plan documents
• No understanding of nuance: AI cannot fully understand the unique circumstances of your situation the way a human professional can
• Document processing errors: Our OCR and text extraction may introduce errors, especially with scanned documents, handwritten notes, or poor-quality images

We include source citations in AI responses whenever possible so you can verify the information against your original documents.

5. Provider Directory Disclaimer

Our “Find Providers” feature uses data from multiple sources:

• Google Places API: Provides location, hours, ratings, and contact information. This data is maintained by Google and the providers themselves, and may be outdated or inaccurate.
• NPPES (National Provider Registry): Provides NPI numbers and specialty classifications. This is a government database that providers self-report to, and may not reflect current practice information.
• CMS Transparency in Coverage data: Provides in-network/out-of-network status based on machine-readable files published by insurers. This data is published monthly and may not reflect real-time network changes. A provider shown as “in-network” may have left the network since the data was last updated.
• User-verified network status: Some network status information is contributed by other users. While we believe this is helpful, user-submitted data is not verified by BenefitGuard or any insurer.

Always confirm a provider's network status, hours, and availability directly with your insurance company and the provider's office before scheduling an appointment.

6. Third-Party Content and Links

BenefitGuard may link to external websites, including government sites (.gov), insurer provider directories, and other resources. We provide these links for your convenience and do not endorse, control, or assume responsibility for the content, accuracy, or practices of any third-party site.

7. No Guarantee of Results

BenefitGuard cannot guarantee that using our Service will result in any particular outcome, including but not limited to:

• Successful claim appeals or dispute resolutions
• Reduced medical bills or out-of-pocket costs
• Accurate determination of your benefits or coverage
• Finding an in-network provider near you

The effectiveness of the information we provide depends on many factors outside our control, including the accuracy of your uploaded documents, the specifics of your insurance plan, and the decisions of your insurer and healthcare providers.

8. Service Availability

BenefitGuard is provided on an “as available” basis. We do not guarantee uninterrupted access to the Service. The Service may be temporarily unavailable due to maintenance, updates, or factors beyond our control. We are not liable for any harm resulting from Service interruptions.

9. Contact Us

If you have questions about these disclaimers, please contact us at legal@benefitguard.app.