How Does Forward Work With Insurance?

Forward
Forward
Published in
4 min readJul 22, 2020

Even before the coronavirus pandemic struck, 45% of Americans were either uninsured, underinsured or experienced a lapse of coverage in the last year. In the midst of the pandemic, as unemployment rates have rivaled those of the Great Depression, the weaknesses of America’s employer-based health insurance system have only come into sharper relief. For many people today, health insurance does not offer stability and certainty because their insurance depends on a job that is itself unstable and uncertain.

The shortcomings of America’s traditional healthcare system do not end there. Surprise bills, long wait times, and outdated systems are commonplace. The prevailing fee-for-service model, where a provider gets paid for each task they perform, seems to encourage more interventions, but without necessarily promoting service quality. It can give the distinct feeling that the healthcare industry benefits from keeping us sick, rather than ensuring we stay well.

Like a lot of people, we grew frustrated with the healthcare industry’s unresponsiveness to such widespread dissatisfaction and poor outcomes. We believe that access to quality healthcare should not depend on a person’s employment situation, immigration status, or income. We also believe that you should not have to choose between housing and healthcare, childcare and check-ups. Ultimately, we believe that being proactive and emphasizing prevention — rather than just reacting to sickness — can help our members get better results at lower costs.

So we set out to build something different: an entirely new model of primary care, designed for people. Forward is built as a membership. Each member pays the same flat monthly fee and gets access to the suite of primary care services we offer. This means you’ll never get a surprise bill from us, and we do not bill insurance or charge co-pays. Our goal is to keep you healthy, not to bill you for services when you get sick.

Forward membership is geared toward addressing many of your primary care needs, while also helping you avoid issues, identify problems early, and control chronic conditions before they become more expensive to treat. Membership includes*:

  • Unlimited in-person and virtual visits and 24/7 messaging with your Forward doctor and Care Team
  • Real-time blood testing, including comprehensive metabolic panels, lipid panels and diagnostic testing
  • Procedures done in our clinic, such as vaccinations, electrocardiograms (EKGs) and skin scans
  • Genetic testing and analysis
  • Women’s health, including pap smears, pelvic exams, birth control counseling, and STI testing
  • Men’s health, such as prostate screening and STI testing
  • Personalized, preventive plans for nutrition, exercise, stress, sleep and weight management
  • Certain chronic condition management and care support services

*In certain states, some of these services are not included in your flat membership fee. We will discuss billing for these services with you before we provide them.

If your Forward doctor and Care Team decide that you need additional tests or procedures that are not included in membership, then we will work to help you try to find a non-Forward option that fits within your budget. If you have insurance, that typically means that we coordinate with your insurance provider to facilitate specialist referrals, prescriptions, or emergency care within your provider network.

Insurance is not required to become a Forward member. However, it is important to understand that Forward membership is not health insurance and does not replace health insurance. We encourage any person (including our members) who can afford it to maintain a separate health insurance plan of their choosing. While Forward membership can help meet certain day-to-day needs, insurance can be important for covering services that are not included in a Forward membership — things like specialist visits, hospitalizations, or ongoing medications and treatments.

Most of our members use Forward as a complement to their insurance. Some decide it is a smart financial strategy to combine a lower-premium high-deductible health insurance plan with Forward membership. The high-deductible insurance can serve as a backstop to cover unforeseen significant needs like hospitalizations, while Forward’s preventive approach meets most day-to-day primary care needs and gives you consultations for a healthy future. Savings can be compounded by paying for Forward membership using a tax-advantaged mechanism like an FSA or HSA.

If you are interested in learning more about Forward, check our website.

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Forward
Forward

Forward is a new approach to primary care that combines world-class doctors and leading-edge technology. Control the future of your health.