Folx Health, a startup that provides gender-affirming hormone therapy for trans people, now accepts health insurance

Health startup Folx, which offers easily accessible gender-affirming hormone therapy (GAHT) to transgender people across the US, just announced that they now accept health insurance.

Folx now accepts health insurance plans from:

• Cigna, which offers coverage throughout the US
• Blue Shield of California
• Blue Cross Blue Shield of Texas
• Evernorth, which is part of Cigna, for behavioral health services in Colorado and Florida
• Optum, for behavioral health services in Colorado and Florida

According to their website, insurance can cover the cost of:

• GAHT, also known as hormone replacement therapy (HRT)
• sexual and reproductive health needs
• primary and preventative care, including wellness screenings and chronic condition management
• mental health support for anxiety, depression, or insomnia

Transgender people face many barriers when accessing HRT

In 2020, CNN Health reported that 1 in 10 transgender Americans use nonprescribed hormones because they're uninsured or can't afford it.

Besides the cost of GAHT, some other barriers to access include:

• Health insurance policies or state legislation that do not recognize gender-affirming care like GAHT as medically necessary
• Letters from mental health professionals with a diagnosis of gender dysphoria required to prove to health insurance providers that GAHT is medically necessary
• In some states, medical professionals may discriminate against transgender people, or they may lack the proper training required to treat transgender people.

Folx was founded in 2020 by queer venture capitalist and healthcare provider AG Breitenstein, JD, MPH to remove those barriers and make it easier for transgender people across the US to get the hormones they need.

Since its inception, the queer-owned and -operated health startup has provided virtual visits with affirming healthcare practitioners and hormones shipped directly to their doorstep in discreet packaging.

Other startups like Plume offer similar services.

Folx has been criticized for the cost of its services

In a recent news article by Fast Company, Lake Willeford, one early user of Folx, paid up to $139 per month for the service, and about $100 for testosterone every three months. "It was a necessity for me, so I prioritized it and set [the money] aside," he told Fast Company.

In 2021, an article in Mother Jones criticized trans telehealth startups like Folx and Plume, for the price of their services. Lil Kalish writes for Mother Jones, "But not everyone sees the services as revolutionary, citing price tags — Plume's $99-per-month fee is typical — suggestive of a focus on profiting from those who can shoulder the cost, rather than dismantling the conditions that push many trans people toward concierge telemedicine in the first place."

Folx has since changed its subscription model to a flat rate of $39 per month. Without insurance, Folx members can expect to pay $159 for an initial provider consultation, $79 for follow-up consultations, and between $45-$582 every three months for HRT, depending on the type of hormones and where you live. The cost of hormones vary per state.

In an interview with Fast Company, Folx says 12% of its visits are covered by insurance, while medication coverage has grown from 5% to 25%.