Blue Shield of California announced they have expanded member access to FOLX, a virtual care provider focused on the LGBTQ community. More importantly, Blue Shield will reimburse the monthly membership fee so Blue Shield PPO health plan subscribers can access the full suite of FOLX services. As FOLX states, they are “Healthcare that’s queer all year.”
Blue Shield and FOLX for Queer Healthcare Services
FOLX describes their services as encompassing primary care, gender-affirming care, and mental health care. All the services and providers are attuned to the specific health care needs of the LGBTQIA+ community. In addition to virtual primary care, FOLX is a mix of patient advocacy and concierge service.
Madison Hamilton of FOLX says they have served over 60,000 queer and trans people in all 50 states. FOLX provides a comprehensive list of virtual primary care including
- General wellness visits
- Treatment of illnesses
- Management of chronic diseases (thyroid, diabetes, high blood pressure, etc.)
- Gender-affirming hormone therapy
- Support for mental health conditions like anxiety or depression
- Sexual and reproductive health
- Fertility and family planning
FOLX Focused on LGBTQ Community Healthcare Needs
Important to many LGBTQ people is interacting with a health care staff with no judgements. FOLX was created by LGBTQ community members and structures the operation to provide a welcoming atmosphere. This extends to vetting referrals to specialists for in-person office visits. FOLX uses a combination of recommendations from their own clinicians, community, and self-attestation of the provider that they are LGBTQ friendly.
When it comes to people in transition, FOLX can provide letters for gender-affirming surgeries. FOLX has also created a fund to provide financial assistance for gender-affirming hormone therapy.
For Blue Shield PPO health plan members, FOLX appointments are treated like any other virtual care provider. The cost-sharing of a primary care visit is determined by the health plan benefits. If your Blue Shield PPO plan has $35 primary care office visits, that will be the copayment to have an appointment with a FOLX clinician.
With prescriptions, FOLX can work with your local retail pharmacy to fill the prescription and process the claim through Blue Shield pharmacy benefits of your health plan. FOLX can also have prescriptions sent to your home. Some limitations to delivery and coverage through the health plan may apply.
Blue Shield will Reimburse FOLX Membership Fee
To use FOLX through Blue Shield of California you will need to join FOLX. The monthly membership fee for FOLX is $39.99. This is the amount that Blue Shield will reimburse you for. The biggest hassle is having Blue Shield send a monthly reimbursement check. The other potential challenge is that the check will be sent to the primary subscriber’s home address. If your parent is the primary subscriber and you don’t want your parent to know of FOLX, this might prevent you from joining FOLX for primary care services.
If I’m alerted that FOLX and Blue Shield have implemented an alternative reimbursement process, such as credit directly to a bank account or credit card, I’ll let you know here. FOLX membership reimbursement is only available to Blue Shield PPO plan members.
YouTube reviewing FOLX and the Blue Shield of California reimbursement.
