Frequently Asked Questions

General FAQ | Member FAQ

Helpie FAQ

Getting Started

  • Where is Plume Available?

    Plume is available in many states and expanding rapidly. See our coverage map for details and sign up for our waitlist by tapping “Get Started” at the top of the page. We’ll let you know when we are active in your state.

  • Your First Appointment

    Your first appointment is a video visit from the convenience of our secure communication app. Your provider will review your health history / intake forms and have a conversation with you about your goals and desires. You’ll work together to develop a treatment plan that is right for you. Your provider can answer any and all questions about the medications, dosage, their effects, how to inject, take, or apply them, and what to expect as you go. Our providers are experts in gender-affirming care and, no matter if this is your first time exploring hormone therapy or you’re a decade in, they are here for you with respect and wisdom.

  • Future Appointments

    No more lengthy office visits! Instead of waiting for appointments, you can message your care team and medical provider instantly using our secure communication app. Seriously, send us a message ANYTIME with your questions, concerns, or needs. Your care team will get back to you ASAP during business hours.

  • How do I start with Plume?

    Plume makes it easy to get expert, safe, and confidential gender-affirming care from the privacy of your home.

    First, determine if you are interested in a Plume membership for gender-affirming hormone therapy. (GAHT or “HRT”) or if you only need a one-time letter of support for surgery. Letters are included in membership. Next, scroll to the top of this page and select “Get Started” to download our app* and schedule your appointment with a Plume medical provider.

    At your appointment, you and your provider will create an individualized treatment plan that works best for you. You can decide after your appointment if Plume membership is right for you. For gender-affirming hormone therapy (GAHT or “HRT”), your provider will send prescriptions to the pharmacy of your choice at the end of your first appointment. [Note: You must be a Plume member to receive a prescription.] For one-time letters, you will receive your letter within a week.

    As a part of your membership, your care team will monitor your progress, check your hormone levels, and review other blood tests as needed to make sure your journey is going smoothly. You can contact your care team directly anytime you need.

    What is the Spruce communication app and why do you use it? Spruce is a HIPAA compliant (Health Insurance Portability and Accountability Act) communications app made specifically for innovative medical practices. Our highest priority is confidentiality and Spruce allows us to keep your sensitive medical information private and secure. It also ensures our conversations are kept private on your phone. Through Spruce you can communicate with your provider by text, phone, or video chat.

  • What if I already have a gender-affirming medication prescription?

    Plume will make it as easy as possible to transfer your prescription, progress monitoring, and labs to our care. Scroll to the top of this page and select “Get Started” to download our app and chat with our care team about the best solution for your current situation.

  • Lab Work

  • How does lab testing work through Plume?

    All routine testing, including hormone monitoring and other blood tests, recommended for gender-affirming care is covered by the monthly membership fee.* Nothing extra needed!

    Without Plume, out-of-pocket labs can range from $150 – $500. You don’t have to worry about that with our membership.

    We order labs through Quest Diagnostics. They have many lab draw sites throughout the country. We place the order, and you go to the nearest Quest lab site to get your blood drawn. We let you know the results with recommendations via our secure app as soon as they come in.

    *New York residents are subject to a law that requires the patient to pay for labs out-of-pocket. To offset this, we have negotiated with Quest labs for reduced cost blood work. Plume will then reimburse New York patients by reducing their membership from $99 to $90.  The reduction in membership will cover the cost of labs with Quest. 

  • Blood work - when, how, and why

    Blood work (aka labs) are an important part of monitoring your health and progress. We recommend doing labs every 3 months. Your membership includes the cost of blood work which is conducted at your local Quest center*. 

    • Your care team will remind you when it’s time for labs. Instructions for scheduling will be in the reminder.
    • Find a Quest center and make an appointment.
    • Schedule using the name that matches your ID and we send them a note alerting them to your chosen name.
    • At your appt, tell them you are getting labs done for Plume Health. 
    • Your medical provider will contact you to discuss the results. 

    *If you live in NY/NJ, you are subject to some weird laws that require you pay for labs out-of-pocket. To offset this, NY/NJ membership costs $90 instead of $99 to cover the cost of labs.

  • Payment & Insurance

  • How much does Plume cost?

    Membership is $99 per month. If you live in NY or NJ, the cost is $90, discounted to offset the out-of-pocket cost of labs. You are charged the same date every month to the credit card we have on file. If you need to update your credit card or the date you are charged, message your care team.

    You cannot use insurance, medicaid, or medicare to pay for Plume. We use a direct payment model to keep costs low. But if you have an HSA, check if you can be reimbursed.

  • How does the cost of Plume compare to out-of-pocket or insurance?

    We made a cost comparison chart to help you determine if Plume is right for you.

  • Is financial support available?

    We have partnered with several non-profits to provide need-based financial support for Plume members. Our HRT Access Fund provides 12 months of free gender-affirming hormone therapy and medications via Point of Pride. You can apply at

    Our partnership with You Are Essential [] raises funds for Black transgender folks to access care.

    Our “Pay it Forward”’ initiative donates directly to the Transformative Freedom Fund. Colorado residents can apply for financial support for medications and surgeries through the Transformative Freedom Fund,

    For surgery-specific financial support around the country, you can apply to Point of Pride’s annual transgender surgery fund,

  • Can I use insurance to pay for my Plume membership?

    We do not accept insurance for our monthly fees. Remaining a cash-only practice allows us to be innovative and cost-effective in providing the care that folks want in the most convenient way possible.  Our service is eligible for Health Savings Accounts (HSA) and we can provide guidance on how to use funds appropriately. Insurance may be used to cover the cost of hormone medication. Check with your insurance provider regarding coverage.

  • Do Medicaid or Medicare cover Plume services?

    Unfortunately, they do not. Remaining a cash-only practice allows us to be innovative and cost-effective in providing the care that folks want in the most convenient way possible. Depending on your program, you may pay for Plume out-of-pocket with no consequences. 

    Restrictions are based on the state you live in and the program you are enrolled in. Plume is not available for recipients of Medicare in any state or Medicaid in Colorado only. For more information about your specific restrictions, please contact your program directly.

  • How do I update my credit card?

    It’s easy! Just message your care team with your new card number, expiration date, three digit code, and if your billing address has changed.

  • All about meds

  • How do I perform an injection?

    Injections can be a bit tricky at first, but we’re confident you will get the hang of it with practice. Message your care team in Spruce to learn or be reminded of how to perform either a subcutaneous or intramuscular injection. We’re always here to support you.

  • How do I change my dose?

    You can discuss it with your provider anytime! Send a message to your provider in the Spruce app.

  • How do I get an Rx refill?

    Relax, your care team will remind you when it’s time to refill your Rx. You will get a message in Spruce that a new refill is being sent either to your local pharmacy or our delivery pharmacy. If anything happens and you need a refill sooner than expected, reach out to discuss it with your care team.

  • Plume Services

  • Does Plume provide letters for name or gender marker changes?

    Yes! To change the name or gender marker on your identification documents (driver’s license, social security card, passport, birth certificate), you often need a letter from your treating medical provider or a form signed by them. You must be a member with Plume to receive name and gender marker letters, we do not provide one-time letters for name or gender marker change.

    Here are some great resources: (Colorado only) (national database) (national database)

  • Does Plume provide letters of support for gender-affirming surgery?

    Yes! We provide letters for both Plume members and non-members. If you are a Plume member, letters are included in your membership. If you are not a member, you can pay a one-time fee of $150 for an appointment with one of Plume’s medical providers, access to our care team for resources and support, and a guaranteed one week turnaround time to issue the letter. If you need a letter from a behavioral health professional, unfortunately we don’t provide those. 

  • Does Plume provide gender-affirming surgery?

    We do not provide gender-affirming surgery, but we do provide letters of support for surgery for both members and non-members. Letters of support are included in the price of membership or as a one-time service. We will also help navigate the process by providing a list of surgeons, referral if necessary, and guidance from our care team.

  • Does Plume provide behavioral health?

    No, but we do encourage a relationship with a behavioral health provider for continued support as we believe this is a valuable resource for all people. 

    If needed, we will help find a local therapist in your area that is competent in gender-affirming care or help connect you with a remote therapist who can be seen from the comfort of your own home via video, text or phone such as: – queer/trans specific – not queer/trans specific but sensitive – not queer/trans specific but sensitive

  • New York and New Jersey residents have a different membership, here’s how

    New York and New Jersey are beautiful states, but have strange laws about paying for laboratory services. 

    Your Plume membership includes the cost of labs. Patients in New York and New Jersey are legally required to pay for lab services out-of-pocket. We have arranged a low rate with Quest labs where you pay out of pocket and we reimburse you for the cost by discounting your monthly membership.

    Monthly membership for New York and New Jersey patients is $90, for all other states it is $99. This way Plume members in NY and NJ will pay the same average of $99 per month as all other members. 

    Get Started With Plume