Choosing a gender-affirming telehealth provider can be an important healthcare decision, and cost is a legitimate part of that. Here's a straightforward breakdown of what you'll actually pay with FOLX Health versus Plume Clinic.
The pricing models
Plume Clinic operates on a flat membership: $99/month, cash pay only, no insurance accepted. That includes up to five provider visits per month. You also have the option of paying $749.99 for the year.
FOLX operates on a lower base membership — $39.99/month or ~$25/month if you pay annually — with visits billed separately: $159 for your first appointment, $79 for follow-ups, if you pay out-of-pocket or “cash pay”.
FOLX also accepts insurance, so members with coverage pay their in-network copay (often $15-30) instead of the full visit rate.
What about medications?
At both Plume and FOLX, your providers write your prescriptions and then you pay for your medications when you order or pick them up. At FOLX you can get your medications delivered to your door via our partner pharmacy or choose to pick them up at a local pharmacy of your choice.
What about lab work?
We recommend most members get lab work once or twice a year. This keeps you healthy and helps you reach your goals. (We’ve published research on this!) With our discounted lab rates, gender-affirming hormone therapy labs done with FOLX cost ~$50, or are billed with your insurance. At Plume, labs are included.
What most patients actually spend
The standard visit cadence for hormone therapy patients is 1 to 2 provider appointments per year — an initial consultation or annual check in, and a follow-up or two as needed. This may or may not include an appointment to discuss lab work — your provider will review your labs and send them via your portal either way.
Here's what that costs annually:
The breakeven point
Plume's pricing becomes cost-competitive with FOLX at cash-pay rates if you're scheduling 8 or more visits in year one, or 9 or more visits per year after that. For patients with insurance through FOLX, that threshold is higher still.
For context, 9 visits per year means seeing your HRT provider roughly every five to six weeks. That's an unusual cadence for most patients.
A note on insurance
FOLX is in-network with Cigna, Aetna, Blue Shield of California, Blue Cross Blue Shield of Texas, and many more. Plume does not accept insurance.
For members with coverage, insurance substantially changes the out-of-pocket comparison.
Scope of services
The two platforms also differ in what they offer beyond HRT.
FOLX members have access to primary care, mental health, and sexual and reproductive health services — all from providers who are familiar with their full health history and the specific context of transgender health care.
What if I need to get in touch with my provider?
At FOLX, you don’t need to schedule a visit to get in touch with your provider or care team. You can always message at any time with questions, and a member of the care team will follow up.
This can be questions about your medications, getting a referral to a gender-affirming surgeon, or anything else you need.
Which is right for you?
Cost is only one element of the decision for most folks. Sometimes it comes down to wanting a single place to manage more of your care. Sometimes you want to see a particular provider that a friend recommended. Or maybe you want access to something else specific — like FOLX’s therapist-led support groups.
But if cost is your main concern, here’s one way to think about it.
If you want a single flat monthly rate and are a cash-pay patient who anticipates wanting to see a provider live frequently (every 1-2 months, or more) Plume's model offers simplicity. Some people are happy to pay more to have consistent costs!
If you want lower baseline costs, the option to use insurance, and access to a broader range of services beyond HRT, FOLX is likely the better financial fit for most patients at most stages of care.
Start your care with FOLX here.
