Question 1

How much does Plume cost?

Accepted Answer

Plume’s gender-affirming hormone therapy (GAHT or “HRT”) membership is a flat-rate of $99/month. Membership includes your recurring prescription for gender-affirming medicines; a customized treatment plan designed with your medical provider; bloodwork at a local Quest lab; instant text message access to your care team; ongoing evaluation and adjustment of treatment; and letters of support for surgery, name change, and gender marker change. The cost of medicines is not included in membership. Medicines cost ~$20 a month on average with cost-saving coupons from Goodrx.

Your first appointment fee is $99, which will be applied to your membership, if you join. If you decide membership is not for you, you will not be charged further, and you may always cancel at any time.

Plume’s letter writing service offers a one-time letter of support for surgery for $150. This includes a medical evaluation; a letter issued within one week of your appointment; and access to your care team for resources and recommendations. This service does not include gender-affirming hormone therapy. Plume’s GAHT membership includes letters at no cost.

Question 2

Your First Appointment

Accepted Answer

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.

Question 3

Future Appointments

Accepted Answer

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.

Question 4

Ongoing Care

Accepted Answer

Our goal is convenience and affirmation.Whenever you have a question, concern, or need, simply message your care team.Blood work is essential to track your health. The cost of labs are covered by your membership. We partner with your local Quest lab to conduct quarterly blood work.Your medical provider reviews your labs and communicates the results and any recommendations to align with your goals.If your goals shift at any time, message your care team and your treatment plan will be reevaluated.If you need letters of medical support for name change, gender marker change, or surgery, just ask and we’ll have it for you within a week.Your team will work to connect you to referrals and resources for surgery and behavioral health.Live your best life.

Question 5

Does Plume provide letters for name or gender marker changes?

Accepted Answer

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:

http://www.namechangeproject.org (Colorado only)

https://transequality.org/documents (national database)

https://transgenderlawcenter.org/resources/id (national database)

Question 6

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

Accepted Answer

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.

Question 7

Does Plume provide gender-affirming surgery?

Accepted Answer

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.

Question 8

Does Plume provide behavioral health?

Accepted Answer

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:

https://www.pridecounseling.com – queer/trans specific

https://www.betterhelp.com – not queer/trans specific but sensitive

https://www.marigoldhealth.com – not queer/trans specific but sensitive

Question 9

How do I start with Plume?

Accepted Answer

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.

Question 10

Communicating With Your Care Team

Accepted Answer

Plume makes it easy to talk with your medical care team. Your care coordinators are available through our secure communication app Mon - Fri 8AM - 6PM and Sat - Sun 9am - 5pm Mountain Time. We will respond ASAP during business hours.

Question 11

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

Accepted Answer

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

Question 12

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

Accepted Answer

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.

Question 13

Is financial support available?

Accepted Answer

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 https://pointofpride.org/HRT-Access-Fund/

Our partnership with You Are Essential [https://www.youareessential.org/plume] 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, https://transformativefreedomfund.org

For surgery-specific financial support around the country, you can apply to Point of Pride’s annual transgender surgery fund, https://pointofpride.org/annual-transgender-surgery-fund/.

Question 14

How does lab testing work through Plume?

Accepted Answer

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.

Question 15

Can I use insurance to pay for my Plume membership?

Accepted Answer

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.

Question 16

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

Accepted Answer

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.

Question 17

Do Medicaid or Medicare cover Plume services?

Accepted Answer

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.

Question 18

Where is Plume Available?

Accepted Answer

We are available in Arkansas, California, Colorado, Florida, Georgia, Maine, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Illinois, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, Virginia, 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.

Question 19

Your Care Team

Accepted Answer

Your care team is composed of your medical provider, care coordinators, clinical manager, and the patient success team who is always working to incorporate your feedback to improve your patient experience.

Plume’s medical providers are all trans-specialists, and many are trans themselves.Your care coordinators, clinical manager, and product designer are all trans. They are your community and show up to support you 7 days a week.

The Chief Medical Officer is Dr. Jerrica Kirkley (she/her), a trans woman, physician and educator. She has been both a patient and provider of gender-affirming hormone therapy (GAHT) and has provided training across the country on gender-affirming care. She started Plume to radically increase access to gender-affirmation services.

Question 20

Schedule an Appointment

Accepted Answer

There are two reasons to schedule an appointment: To begin your Plume membership or to discuss with a medical provider if gender-affirming hormone therapy (GAHT or “HRT”) or Plume are right for you. Scheduling is easy! Just tap “get started” at the top of this page and download our secure app. You will be guided through our medical intake process that helps prepare your medical provider with important information about who you are, your health, and your goals. After you schedule, we will connect you with your care team to answer any questions you have.

Question 21

How does Plume work?

Accepted Answer

The Basics

Membership is $99 / month and includes:

Digital video appointments with your trans-specialist medical provider.Collaborative treatment planning with your medical provider, based on your goals and their expert knowledge. Ordering, analysis, and cost of all labs.A medical care team who specializes in gender-affirming care.24/7 text access to your care team and response within an hour during business hours, Mon - Fri 8AM - 6PM and Sat - Sun 9am - 5pm Mountain Time.Digital video appointments from anywhere.You and your medical provider will evaluate your goals and establish an appropriate hormone treatment program.Ongoing progress monitoring. Your care team will track your progress with quarterly evaluations and treatment adjustments as needed.Prescriptions for gender-affirming medications as needed sent to the pharmacy of your choice.Letters for name or gender marker change or surgery.Connections to resources for primary care, mental health, and more.A trans and queer-led team cheering you on every step of the way.

We are cash-based, which means that insurance, Medicare, and Medicaid do not cover the cost of membership.

*The cost of medication is not covered by your membership. Gender-affirming medication ranges from $5 - 50 per month depending on medication. We recommend GoodRx for coupons. Insurance may be used to cover the cost of hormone medication, but not the Plume service. Check with your insurance provider regarding coverage.

Membership is $99 / month and includes:

Digital video appointments with your trans-specialist medical provider.Collaborative treatment planning with your medical provider, based on your goals and their expert knowledge. Ordering, analysis, and cost of all labs.A medical care team who specializes in gender-affirming care.24/7 text access to your care team and response within an hour during business hours, Mon - Fri 8AM - 6PM and Sat - Sun 9am - 5pm Mountain Time.Digital video appointments from anywhere.You and your medical provider will evaluate your goals and establish an appropriate hormone treatment program.Ongoing progress monitoring. Your care team will track your progress with quarterly evaluations and treatment adjustments as needed.Prescriptions for gender-affirming medications as needed sent to the pharmacy of your choice.Letters for name or gender marker change or surgery.Connections to resources for primary care, mental health, and more.A trans and queer-led team cheering you on every step of the way.

We are cash-based, which means that insurance, Medicare, and Medicaid do not cover the cost of membership.

*The cost of medication is not covered by your membership. Gender-affirming medication ranges from $5 - 50 per month depending on medication. We recommend GoodRx for coupons. Insurance may be used to cover the cost of hormone medication, but not the Plume service. Check with your insurance provider regarding coverage.

Question 22

How do I cancel my membership?

Accepted Answer

For current members:

There’s no contract with Plume membership. It’s easy to cancel, just message your care team from within the app. If you have active prescription refills, they will be cancelled.

Question 23

What gender-affirming medications does Plume prescribe?

Accepted Answer

We prescribe testosterone, estrogen, and testosterone blockers. Your medical provider will create a customized treatment plan, which includes prescriptions to help align your physical body with your gender.

Question 24

What if I’m having a mental health crisis?

Accepted Answer

While Plume facilitates access to behavioral health resources, we do not offer urgent or emergent support for behavioral health emergencies. Those experiencing a mental health crisis should call the Trans Lifeline at 877-565-8860 or the National Suicide Prevention hotline at 1-800-273-8255.

LGBTQ+ youth should call The Trevor Project lifeline at 1-866-488-7386 or visit https://www.thetrevorproject.org for additional resources.

Question 25

What if I have an emergency?

Accepted Answer

Plume does not provide emergency medical services. Those experiencing crises or emergencies should call 911 or go to the nearest emergency room.

Question 26

Can Plume be my primary medical care provider?

Accepted Answer

Plume is not a primary care provider; all treatments specifically focus on gender affirmation. Your Plume medical provider will evaluate your goals and establish an appropriate hormone treatment program, track your progress with quarterly evaluations and adjust treatment as needed; order and analyze all labs; write the prescriptions and send them to your local pharmacy; connect you to resources, and provide letters for name change or surgery.

Plume strongly recommends that any patient has a primary care provider to attend to other medical conditions and routine care. We are happy to offer suggestions for a primary care provider that is sensitive to gender diversity/queer identity if needed.

Question 27

Is the cost of medication included in my membership?

Accepted Answer

The cost of medication is not covered by your membership. Out of pocket, gender-affirming medication ranges from $5 – 50 per month depending on medication. We recommend GoodRx for coupons.

Insurance may cover the cost of hormone medication, but not the Plume service. Check with your insurance provider regarding coverage.

Question 28

What services are included in membership?

Accepted Answer

Everything to start, continue, and maintain your gender-affirming care.

A digital video appointment with your trans-specialist medical provider to get started.Collaborative treatment planning with your medical provider, based on your goals and their expert knowledge. Ordering, analysis, and cost of all labs.A medical care team who specializes in gender-affirming care.24/7 text access to your care team and response within an hour during business hours, Mon - Fri 8AM - 6PM and Sat - Sun 9am - 5pm Mountain Time.Texts and calls with your provider, as needed.Ongoing progress monitoring, quarterly evaluations, and treatment adjustments, as needed.Prescriptions for gender-affirming medications sent to the pharmacy of your choice.Letters for name or gender marker change or surgery.Connections to resources for primary care, mental health, and more.A trans and queer-led team cheering you on every step of the way.

NOTE: The cost of hormone medication is not covered by your membership. Hormone medication ranges from $5 – 50 per month depending on medication. Coupons are often available; we recommend GoodRx.

Question 29

What if I am not sure if hormone therapy or the Plume membership are right for me?

Accepted Answer

This is a deeply personal process, and we are here to help! The best next step is to have an appointment with one of our trans-specialist medical providers. Scroll to the top of this page and select “Get Started” to download our app and schedule.

You can discuss all of your needs, desires, and concerns with your medical provider. The appointment fee is $99, and there is no obligation to start a membership after your appointment. If you become a member, your appointment fee will be applied to your subscription. You must be a Plume member to receive a prescription for gender-affirming medicines.

Question 30

What can I expect from my first appointment?

Accepted Answer

Your provider will start by reviewing your health history / intake forms and opening up a conversation about your goals and desires. You’ll work together to figure out 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. You can decide if a Plume membership is right for you, and, if you become a member, you’ll get a prescription for your medication, same day!

Your first appointment fee is $99, which will be applied to membership if you join. You must be a Plume member to receive a prescription for gender-affirming medicines.

Question 31

How do I make an appointment with a Plume medical provider?

Accepted Answer

Plume’s medical providers are here to discuss your goals, needs, desires, questions, and concerns regarding gender-affirming hormone therapy (GAHT or “HRT”).

Tap “Get started” at the top of the page, and download our appGo through our medical intake process and schedule with one of our trans-specialist medical providers.See your provider via video visit!

Note: The average wait time for a visit is under two weeks, and our care team is available for questions leading up to your appointment.

Your first appointment fee is $99, which will be applied to your membership if you join. If membership is not right for you, you will not be charged further. You must be a Plume member to receive a prescription for gender-affirming medicines.

Question 32

How do I get a gender-affirming hormone therapy (GAHT aka “HRT”) prescription?

Accepted Answer

You’ve come to the right place. Plume specializes in gender-affirming care, including hormone therapy.

Tap “Get started” at the top of the page.Go through our medical intake process, via our app, and schedule with one of our trans-specialist medical providers. Your first visit is $99.Have your video appointment. Determine the best treatment plan to meet your goals with your provider.Decide if the Plume membership is right for you. If you sign up, your visit fee will be applied to your membership ($99/month).If you become a Plume member, you can pick up your prescription the same day as your appointment! [Note: health concerns may affect your provider’s recommendations and you must be a Plume member to receive a prescription.]

That’s it!

Membership is a recurring monthly investment of $99 which includes:

Ongoing issuing of your prescriptions, sent to the pharmacy of your choice.Ongoing evaluation of progress toward your goals.Quarterly blood work to monitor hormone levels. This is essential for tracking your health. We partner with your local Quest lab to conduct blood work.Convenient messaging with your care team from your smartphone.Text messaging with your provider. No phone trees or long appointment wait times.Letters of support for surgery, name change, or gender marker change.Access to resources and referrals for surgery and behavioral health.

Question 33

Who is Plume for?

Accepted Answer

Plume is for anybody 18 years of age or older who desires gender-affirming care.

AgenderAndrogyneAndrogynousBigenderFTMGender ExpansiveGender FluidGender NonconformingGender QuestioningGender VariantGenderqueerIntersexMTFNeutroisNonbinaryPangenderThird GenderTransTrans ManTrans PersonTrans WomanTransfeminineTransmasculineTwo-SpiritUndefinableWhatever your gender!

How Plume Works

Nonbinary Care

Gender-Affirming Hormone Therapy 101: Introducing the #HRTSavesLives Campaign

What is Gender-Affirming Care?

HHS Rollback of Transgender Healthcare Protections: A letter from our Co-Founders

Why Plume?

Get Started With Plume