The Barriers to Early Interventions: Who Gets To Age Well?

If prevention is the smartest investment, why is our healthcare system set up to make it so hard?

In Part 1, we made the case for starting young, for seeing aging prevention as something to engage in long before our hair turns gray. But here’s the challenge: even if you want to begin early, the system is not designed to make it easy.

Cost: The First Gate

Most aging interventions sit outside the insurance model. An advanced biomarker panel can cost several hundred dollars. An epigenetic clock test is $300–$500. A concierge preventive medicine membership often runs $2,000–$5,000 a year, not including labs and prescriptions. Even basic supplements like Vitamin D, omega-3s, adaptogens, or NAD boosters can add up to hundreds of dollars each month when taken consistently. The result is that many of these interventions are effectively reserved for people with disposable income. For the rest, prevention defaults to “just eat right and exercise,” without the data or guidance that could make those efforts precise and effective.

Insurance Design and the “Sick-Care” Bias

Health insurance, as it is structured today, is mostly reactive. It pays for treatment when something is wrong, not for optimizing what is right. Even when preventive services are covered, such as annual exams, mammograms, or colonoscopies, there are often surprises: out-of-pocket costs, network restrictions, or unmet deductibles. Studies show that around 40% of preventive visits in the U.S. still generate a bill, which discourages people from returning. And insurers think in short-term horizons. If you are 30 today, why would your insurer pay for an intervention that might prevent dementia at 80? By then you will likely be with another insurer, so the cost savings will not benefit them.

Knowledge and Awareness

Another barrier is simply knowing what is possible. Many people don’t know these tools exist, or assume they are only for celebrities and Silicon Valley biohackers. Health literacy plays a major role. People with higher education and better access to health information are more likely to discover, afford, and adopt early interventions. Those with less access may not even know what to ask for.

Structural and Social Barriers

Even if you know what you want, access is not guaranteed. Geography matters: longevity clinics and functional medicine providers are clustered in urban centers, while rural areas often have only basic primary care. Time is another barrier. Many interventions require frequent visits, labs, or coaching calls, which are difficult to manage if you are working multiple jobs or caring for family members. Trust is also a factor. Communities with a history of medical racism or bias may be understandably skeptical of paying for untested, out-of-pocket interventions.

The Inequity Problem

All of this creates a growing divide. One group uses precision diagnostics, strength training protocols, and anti-aging compounds to stay vital into their 80s and 90s. Another manages multiple chronic diseases by 60 because they never had access to those options early on. This is not just a personal issue, it is a public health concern. If we want a society where more people live well, not just live long, we need to address this access gap now.

Where We Go Next

In Part 3, we'll explore how gender and biology make this even more complex—why women and men age differently, why they use preventive care differently, and what solutions might make aging interventions more equitable for everyone.

Your Turn

Where do you feel the biggest barriers? Cost, awareness, or skepticism about whether these interventions work? Let’s map the obstacles clearly so we can start imagining what a truly accessible future of longevity might look like.