What's covered, what isn't.
We keep this simple and transparent - here's exactly how insurance works alongside your partnership or à la carte services at Forged.
Two charges, two purposes.
Billed directly to you
Your monthly membership fee covers the wellness program itself — the parts insurance was never designed to pay for.
- Body composition tracking & biometrics
- Coaching touchpoints & program access
- Secure messaging & care coordination
- Never submitted to insurance
Billed to insurance, when eligible
When a visit or service is medically necessary and insurance-eligible, we bill that portion separately — it's never part of your membership charge.
- Medically necessary office visits
- Certain lab work, when clinically indicated
- Submitted only for in-network, eligible plans
- Coverage varies by plan and isn't guaranteed
Insurance plans we accept for Hybrid Partners or Insurance based, Pay-as-you-go, medically necessary visits
Please ensure we're in-network with your insurance if you plan on using insurance. Insurance coverage varies by plan; coveraged is not guaranteed.
- Blue Cross Blue Shield Montana
- First Choice Health Network (in process)
- Aetna (in process)
- Mountain Health Co-op
- Pacific Source (in process)
- Allegiance
- Cigna
We DO NOT accept: Range Health (Medicare Advantage), United Healthcare, Medicare Advantage, Humana Medicare Advantage, Medicaid
We currently do not accept Medicare
What you're probably wondering.
Do you accept insurance? +
We're in-network with select insurance plans and can submit claims on your behalf for covered clinical visits and services — for example, medically necessary office visits or certain lab work. The majority of our services are not billable to insurance (health coaching, nutrition and personal trainer, body comp scans, injections/IVs, many advanced labs or functional medicine type panels, etc.). We recommend confirming we're in-network with your insurance if you plan on using your insurance/go the Hybrid route.
Is my membership billed to insurance? +
No. Your membership fee is separate from insurance and covers the wellness program components of your plan — things like body composition tracking, coaching touchpoints, IVs, injections and program access. When a visit or service within your plan is medically necessary and insurance-eligible, we bill that portion to your insurance separately; it is not part of your monthly membership charge.
Why doesn't insurance cover most longevity or wellness services? +
Insurance is generally built to cover the diagnosis and treatment of existing conditions, not proactive optimization or prevention (with exception of your yearly annual with your PCP). Forged is focused on proactive, longevity-driven care — which is exactly the gap membership and à la carte pricing are designed to fill. When something crosses into medically necessary, diagnosis-driven territory, that portion becomes insurance-eligible.
How do I know if a specific visit will be covered? +
Coverage depends entirely on your individual plan — deductible, network status, and covered services all vary. We're happy to submit claims where appropriate, but we can't guarantee coverage or reimbursement. We recommend verifying your specific benefits directly with your insurance provider before your visit; confirming your coverage is ultimately your responsibility.
What if my insurance doesn't cover a service? +
Any service that isn't covered — in full or in part — becomes your responsibility as a self-pay charge at our standard rate. We'll always let you know up front when something falls outside typical insurance coverage so there are no surprises.
Can I use my HSA or FSA? +
Many clinical services qualify as HSA/FSA-eligible expenses. We recommend confirming eligibility with your plan administrator, and we're happy to provide an itemized receipt or superbill upon request to support reimbursement.