Yes, Folx Health takes insurance from some nationwide and regional providers, but not from Medicaid or Medicare.
Folx Health is a healthcare provider for the LGBTQIA+ community that offers virtual and in-person care for various needs, such as gender-affirming hormone therapy, sexual and reproductive health, primary and preventive care, mental health care, and fertility and family building.
In this article, we will explain how insurance works at Folx Health, what plans are accepted, and what options are available for uninsured individuals.
Insurance Coverage at Folx Health
Folx Health is in-network with several insurance plans, so you may use your insurance to pay your copays, coinsurance, or deductible. Gender-affirming hormone therapy (GAHT, also known as HRT), sexual and reproductive health, primary and preventive care (wellness screenings and chronic condition management), mental health support for anxiety, depression, or insomnia (and counseling/therapy in some states), and more may be covered by your health insurance.
The insurance plans that Folx Health accepts are:
- Blue Shield of California (BSC)
- Blue Cross and Blue Shield of Texas (BCBSTX)
- Cigna (national coverage)
- Evernorth (part of Cigna): Behavioral Health services in Florida
- Optum: Behavioral Health service in Colorado and Florida
Folx Health is working to accept more insurance plans all the time, and you can find out when they launch new plans by signing up for their newsletter.
If Folx Health does not accept your insurance, then you will have to pay their “cash pay” prices, which are listed on their pricing page. You can also use your insurance to help cover prescription costs, or use it for care if Folx Health refers you to an in-person provider. Check with your insurance for exact coverage.
How Insurance Works at Folx Health?
If you have an insurance plan that is in-network with Folx Health, then you will be able to pay your regular copay for your visits. A copay for a virtual primary care visit or a gender-affirming hormone therapy visit often ranges from $15-$30. For care cost estimates, call your insurance carrier at the number on the back of your card.
In addition to your copay or coinsurance, you will also have to pay a membership fee to access Folx Health’s services. The membership fee is $39.99/month or $299/year, and it includes:
- Easy appointment scheduling
- Folx community platform
- Peer-led support groups
- Letter writing services
- Referral network
The membership fee is not covered by insurance, and it is required for all Folx Health members, regardless of their insurance status. The membership fee helps Folx Health provide high-quality and affirming care for the LGBTQIA+ community.
Medicaid and Medicare Coverage at Folx Health
Currently, Folx Health does not accept Medicaid or Medicare, as they are not in-network with these programs. This means that if you have Medicaid or Medicare, you will have to pay the full cash pay prices for your visits, labs, and medications at Folx Health. You will also have to pay the membership fee to access their services.
However, you may be able to use your Medicaid or Medicare to cover some services that Folx Health refers you to, such as lab work, specialist care, or in-person care. You will have to check with your Medicaid or Medicare provider to see what is covered and what is not. You may also be able to use your Medicaid or Medicare to help pay for your prescriptions, depending on your plan and pharmacy.
Folx Health is working to become in-network with Medicaid and Medicare in the future, as they want to make their care accessible and affordable for everyone. You can sign up for their newsletter to get updates on their progress and availability.