Telemedicine Startup Focuses On Sexual & Repro Care For Underserved Communities

When it comes to sexual and reproductive healthcare in the United States, the landscape isn’t as progressive or accessible as you’d think. With a relentless amount of anti-abortion, anti-trans bills being pushed on the state level, to your zip code, skin color and bank account determining the type of care you get, it’s clear our current system is ripe for innovation. If COVID-19 has taught us anything, it is that fact alone!

Thankfully, we are seeing numerous innovative ventures being launched that are working to bridge the gap to ensure healthcare access is a human right, rather than a privilege. With telemedicine becoming increasingly popular due to the Pandemic, as well as “healthcare deserts”, the intersection of medicine and tech has never been more important.

One company that recognizes this need is Twentyeight Health, a telemedicine startup focused on providing sexual and reproductive care to underserved communities. Twentyeight Health was named one of the Best Birth Control Delivery Services of 2021, and one of the Most Disruptive MBA Startups of 2020. The company recently raised $5M in funding, and is using the funding to scale its team and launch in states across the US. 

It was co-founded by Amy Fan, a first-generation immigrant who started Twentyeight Health after experiencing firsthand how difficult it is to navigate healthcare access in the US. She founded the company while pursuing her MBA & MPH at UC Berkeley. We spoke with the entrepreneur about why the company is keen to help underserved communities, the dismal stats around sexual and reproductive care in America right now, and how her own experience played a role in shaping this focus.

Amy Fan, founder and CEO of Twentyeight Health

Tell us how the idea for Twentyeight Health came about and where the name came from?

Twentyeight Health is a telehealth company that’s focused on increasing access to high-quality sexual and reproductive care for underserved communities.

I moved to the US from Canada a few years before starting Twentyeight Health, and quickly experienced how difficult it is to get care — even with insurance. I had previously worked at a skincare company in New York City, and wanted to bring the consumer-centric approach from beauty to healthcare to build dignified patient experiences. This led me to start Twentyeight Health. The name comes from the average number of days in a menstrual cycle. 

As a first-generation immigrant, what were some of the biggest barriers to healthcare access you saw among your family members that made you want to change things?

My family immigrated from Taiwan to Canada in 1996. Struggling to find jobs initially, my parents relied on Canada’s universal healthcare to ensure my sister and I got any medical care needed, from basic vaccines to urgent care. I didn’t realize how much healthcare access can vary until I moved to the U.S. in 2014, after finishing my undergraduate degree at Queen’s and working at Bain’s Canada headquarters for three years. 

I joined a NYC-based venture studio to build a telemedicine platform for dietitians, and later led Onomie Beauty, where our team developed and launched Allure Best of Beauty-winning products. Simultaneously, I struggled to navigate my insurance restrictions to find a PCP and OB GYN.

I decided to pursue an MBA & MPH at UC Berkeley. There, I connected with Bruno Van Tuykom, whose experience at the Gates Foundation led him to similar passions for increasing healthcare access. We wanted to leverage technology to address the largest gap in healthcare – access for underserved communities.

Why are you personally passionate about sexual and reproductive healthcare access?

In addition to my personal experience of struggling to access sexual and reproductive care in the U.S., my passion for increasing care access for underserved communities has only grown since launching Twentyeight Health in late 2018. 

Every Friday, our team gathers virtually to hear stories we’ve received from our customers from the past week. These stories are constant reminders of the millions of people across the U.S. who have been laid off, lost access to health insurance, or can no longer visit in-person clinics safely. Staying close to these stories helps us understand the many different types of difficult situations women in the U.S. are facing throughout the pandemic when it comes to accessing sexual and reproductive care, and motivates us to try and help in a meaningful way.”

Sexual and reproductive healthcare is still so taboo in America in 2021, as evidenced by so much backlash and pushback on progressive bills that make healthcare more accessible. How does Twentyeight Health work to bypass the stigma?

Making it easier to get evidence-based sexual and reproductive health information is a key part of our mission. According to Guttmacher, only 17 states require sex and HIV education programs to be medically accurate. For many young women, this makes it challenging to get trusted information, especially when if there is stigma to talking about sex and reproductive health with their family or friends. That’s why we have doctor-vetted sexual education content available to everyone on our website. Additionally, our users can message their doctor on our platform at any time, discreetly and confidentially.  

We are also strong advocates for healthcare access. We write op eds on the topic, as well as post on our blog and speak at conferences and on podcasts. The more people in the healthcare community are out talking to people about why it’s so important for all women to have access to the sexual and reproductive care they need, the more hopeful I am that we can move past this stigma. 

The company was named one of the most disruptive MBA startups in 2020, and one of the best birth control delivery services of 2021. Can you tell us what you are doing different to other digital birth control companies on the market?

I’d say our difference is that everything we do at Twentyeight is focused on providing underserved communities with access to sexual and reproductive care.

Today, low-income women are three times more likely to have an unintended pregnancy than the average woman in the US, and nearly one-third of physicians nationwide aren’t accepting new Medicaid patients. This underscores why offering high-quality reproductive care that is inclusive of people across race, income bracket, or health insurance status is more important than ever.

Twentyeight Health accepts Medicaid in the majority of states where we’ve launched. This is more important than ever before — state Medicaid enrollment has increased an average of 11% between February and September of 2020, with an even higher growth rate of 22% for states with Medicaid expansion. Twentyeight Health is also working to provide free birth control for women who are not able to pay out of pocket and are uninsured, through a partnership with Bedsider’s Contraceptive Access Fund. We donate 2% of revenues to Bedsider and the National Institute for Reproductive Health.

Why do you think we are seeing so many birth control and telemedicine apps being launched?

There’s two major trends. First, consumer and clinician adoption of telemedicine skyrocketed in the last year, with the latter facilitated by changes to telemedicine reimbursement policies. Second, there is a growing shift of the consumerization of healthcare, putting choice back in the hands of patients.

For the women we serve, physically getting to a clinic was already a challenge. Low-income patients often cite lack of affordable transportation and inability to take time off of work or school as reasons why they miss appointments. Telemedicine provides additional convenience and accessibility without sacrificing quality of care. 

The company just announced more availability across the US, making it available in a total of 12 states right now. Can you talk about how your team is also working to make the service available to underserved communities especially?

We increase access to care for women from underserved communities in five key ways:

First, on the affordability side, we’ve partnered with Bedsider’s Contraceptive Access fund to provide a year’s worth of birth control for free to women in need. Additionally, we accept Medicaid in the majority of states we’re available in. 

Second for women who come to us with health insurance, whether that is Medicaid or commercial insurance, we dedicate significant resources to help them understand their coverage and to find $0 or low copay options that are deemed medically appropriate by the physician. 

Third, on the accessibility side, we want to meet women where they are. We provide an optional audio consultation and direct messaging with the doctor at no additional charge. Flexibility is important because women in underserved communities may have a harder time finding privacy. 

Fourth, as we continue to expand across states, we’re actively partnering with nonprofits and other organizations that help women in other parts of their life, such as food security or support reentering the workforce. We want to make it easier for women to navigate the healthcare system, and we are bringing reproductive & sexual health education and services to places they are already connected to. 

Lastly, as I mentioned once before, we donate 2% of revenues to Bedsider and the National Institute for Reproductive Health, to support their work to improve reproductive and sexual healthcare education. 

Can you talk about the injustice of someone’s healthcare access being determined by their zip code, skin color, bank account and gender in America today?

Access to high-quality healthcare should be a universal right — regardless of zip code, skin color, bank account, or gender. Anything short of this reality is unacceptable, period. Through my work, I constantly hear stories of people who have been denied care, or simply can’t afford it. No matter how many times you hear these stories, they’re always heartbreaking. Every day, the team at Twentyeight Health is working towards a world where everyone in the U.S. can access high-quality, affordable care.

With COVID making healthcare access even more precarious in many ways, how is Twentyeight Health working to fill the gaps?

The negative impacts of COVID have been disproportionately felt by low-income communities and people of color. Affordable telemedicine services are more important than ever before to ensure safe access to preventive care. Twentyeight, along with many other telehealth providers, have shown that during a pandemic where in-person interactions carry inherent risks, virtual doctor visits can fill large parts of the healthcare access gap. 

Where will you be expanded next, and where can people sign up to learn more?

Twentyeight Health will be operational in more than 20 states by the summer! To stay up to date, sign up for our newsletter at and follow us on Instagram @twentyeighthealth.

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