Which insurance plans does FOLX accept?

  • Updated

We accept several nationwide and regional insurance plans for visits! At this time, we do not accept Medicaid or Medicare.

If FOLX takes your insurance, then you will be able to pay your regular copay, coinsurance, or deductible for your visits.

Please note: If you have more than one insurance plan, coordination of benefits rules determine which plan pays first. FOLX cannot bill a secondary insurance plan as your primary insurance. If your primary insurance is not one of the plans FOLX accepts, you may need to use self-pay for FOLX services and contact your insurance plans directly about any reimbursement options.

We currently accept:

Insurance Provider

States Covered

Services Covered

Notes

Aetna
National coverage Primary Care & Gender Affirming Care
Includes coverage under Meritain Health
CA, CO, FL, IA, KS, MO, NC, NJ, NM, NV, NY, OH, OR, SC, TN, TX, VA, WA Therapy
Baylor Scott & White Health Plan (BSW) TX Primary Care & Gender Affirming Care  
TX Therapy
Blue Shield of California (BSC)
CA, IL, MA, MD, MI, MN, MT, NJ, NC, PA, TX Primary Care & Gender Affirming Care Blue Shield of California is covering your monthly membership fee - learn more here!
CA, MI, NC, TX Therapy
Blue Cross and Blue Shield of Illinois (BCBSIL)
CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care If your member ID indicates an HMO or IPA plan, we are likely not in-network
CA, MI, NC, TX Therapy
Blue Cross Blue Shield of Massachusetts
National coverage Primary Care & Gender Affirming Care
Blue Cross Blue Shield of Massachusetts is covering your monthly membership fee - learn more here!
FEP plans are currently not covered outside of Massachusetts
CA, CO, FL, GA, IA, KS, MI, MO, NC, NM, NV, NY, OH, OR, SC, TN, TX, VA, WA Therapy
Blue Cross Blue Shield of Michigan (BCBSMI) CA, HI, IL, MA, MI, MD, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care Except Blue Cross Network
MI Therapy
Blue Cross and Blue Shield of Minnesota (BCBSMN)
CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care  
CA, MI, NC, TX Therapy
Blue Cross and Blue Shield of Montana (BCBSMT)
CA, IL, MA, MD, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care  
CA, MI, NC, TX Therapy
Blue Cross of North Carolina (BCNC)
CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care  
CA, MI, NC, TX Therapy
Blue Cross and Blue Shield of Texas (BCBSTX)
CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care  
CA, NC, MI, TX Therapy
Capital Blue Cross
CA, IL, MA, MD, MI, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care  
CA, NC, TX Therapy
CareFirst BlueCross BlueShield of Maryland
CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care  
CA, NC, TX Therapy
CareSource
GA, IN, OH Primary Care & Gender Affirming Care  
OH Therapy
Cigna National coverage Primary Care & Gender Affirming Care Therapy services covered through Evernorth in select states only.
Evernorth CA, CO, FL, IA, KS, VA, MO, NJ, NM, NV, NY, OH, OR, SC, TX Therapy services Part of Cigna
Fallon Health MA Primary Care & Gender Affirming Care  
Hawaii Medical Service Association CA, HI, IL, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care The Blue plan in Hawaii
Highmark CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care
Horizon Blue Cross Blue Shield of New Jersey

 
CA, IL, MA, MD, MI, MN, MT, NC, NJ, PA, TX Primary Care & Gender Affirming Care FOLX is not in-network with Horizon EPO products currently
CA, NC, TX Therapy services
Meritain Health
National coverage Primary Care & Gender Affirming Care
Meritain Health is an Aetna company
CA, CO, SC, TX, VA Therapy
Optum CA, CO, FL, IA, KS, NC, NJ, NM, NV, NY, OH, OR, TN, TX, VA, WA Therapy services If you have UHC, FOLX is INN for therapy services only, via Optum
Priority Health
National coverage Primary Care & Gender Affirming Care  
CA, CO, FL, IA, KS, VA, MO, NM, NY, OH, OR, SC, TX Therapy
Select Health Idaho ID Primary Care & Gender Affirming Care  
Select Health Utah UT Primary Care & Gender Affirming Care FOLX is in-network with Care and Choice networks only
Wellfleet Student
National coverage Primary Care & Gender Affirming Care Covered by Cigna
CA, CO, FL, IA, KS, VA, MO, NM, NY, OH, OR, SC, TX Therapy Covered through Evernorth

Please note: for all Blue Cross Blue Shield plans, unless indicated in the list of states above, members need to be located in their plan's state in order for FOLX to be considered in-network. Additionally, FEP plans are currently not covered outside of Massachusetts.

If you don’t see your insurance or state listed here, don’t worry - we're continuing to add new plans. You may still be able to use your insurance at the pharmacy of your choice for any medications your clinician may order for you as well as to pay for labs at a non-Quest lab facility. If you’d like to use insurance to pay for your medications, make sure to keep your preferred pharmacy current on the Billing page of your FOLX account.

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