TABLE OF CONTENTS

• Can I use insurance to pay for my Plume membership?
• Who is eligible for using insurance?
• I'm a new member, how do I submit my insurance information?
• I'm a current member, how do I submit my insurance info?
• How does Plume bill my insurance?
• How much is a membership with insurance? 
• How do I pay my copay?
• When will I need to pay my copay?
• My insurance denied the claim from Plume, what do I do?
• I have a question about my insurance billing, what do I do?
• Does Plume charge a copay or expense member per visit line item?
• I don't see Plume on my Explanation of Benefits (EOB).
• Can I use an HSA or FSA to pay for my Plume membership?
• How do I enter my insurance information as a current member?

Can I use insurance to pay for my Plume membership?

Plume members based in select states with certain commercial insurance policies may be eligible to use their insurance to get a reduced out-of-pocket cost for a Plume membership. Check out the table below to see if you may be eligible. Reach out to your Care Team in Spruce with any questions or email us at [email protected]. 

Other than active members with eligible insurance policies, we do not currently accept insurance for our monthly fees. We are working to provide this option soon and will provide updates as coverage expands.

Who is eligible for using insurance?

Plume members in selected states with eligible insurance plans may qualify for a reduced membership rate. See below for more details. Please note that we do not accept Health Maintenance Organization (HMO) insurance plans at this time.

*TriWest states with some ZIP codes in the East Region. For more information please visit TriCare FAQs, specifically the "What's my TRICARE region?"

If we don’t currently take your insurance, please stay tuned. Our goal is to accept most commercial health plans in a majority of the states by the end of the year, pending approvals.

I'm a new member, how do I submit my insurance information?

You will have an opportunity to select your insurance carrier using the drop-down menu after entering your email, state, date of birth, and name.

I'm a current member, how do I submit my insurance info?

If you are currently an active Plume member, reach out to your Care Team in Spruce and we will send you the insurance form. Once you complete the form we will confirm your eligibility.

How does Plume bill my insurance?

For eligible insurance members — after a video visit with one of our providers, Plume will submit a claim with necessary details to the payer, aka your insurance company, for processing. The insurance company will assess our claim to determine how much they will pay. In order to submit this claim, we will use a secure, industry standard process requiring us to include your contact information, dates of service, and various diagnostic and procedure codes (the same way a doctor you may have seen submits a claim). The insurance company will send a form back to Plume explaining how and when the claim was paid. You will also have access to this information through your insurance company's portal in the form of an Explanation of Benefits. The explanation of benefits will explain how your insurance company paid the claim.

How much is a membership with insurance? 

Eligible members will pay $32 per month out of pocket for their membership + co-pays for any virtual appointment with your provider . 

How do I pay my copay?

For members using eligible insurance to reduce membership cost, you will receive an automated email with a digital statement and instructions on how to pay. 

When will I need to pay my copay?

A copay will be required for all video appointments with your provider, such as your initial intake appointment and all follow-up appointments. 

My insurance denied the claim from Plume, what do I do?

We will recheck eligibility on the date of service for anyone using their insurance to ensure your insurance is active. We will also check on a monthly basis, but the most important check is the day of service. If for some reason your insurance coverage was no longer available the day of scheduled service, we simply would not submit a claim for that service, and your membership would revert back to the standard out-of-pocket amount of $99.

I have a question about my insurance billing, what do I do?

Please reach out to the Care Team in Spruce or at [email protected] with any questions and concerns.

Does Plume charge a copay or expense member per visit line item?

While we do not waive patient responsibility to pay for any medical expenses their insurance does not cover, we are not charging copay or billing visit expenses per line item. 

I don't see Plume on my Explanation of Benefits (EOB).

If you are enrolled in a $32 insurance package with Plume and you do not see a Plume related claim in your Explanation of Benefits, it is likely that we have not yet filed the claim. Please allow up to 120 days for the claim to appear. Any questions can be sent to your care team via Spruce or by emailing us at [email protected].

Can I use an HSA or FSA to pay for my Plume membership?

Yes, Plume membership is eligible for Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) spending. You can use your HSA/FSA-issued credit card as your payment method for Plume. We can also provide a detailed invoice for each of your monthly payments to submit to your insurance for reimbursement. While we cannot guarantee they will accept your submission, we are more than happy to assist in providing documentation of membership payments. You may also use your HSA or FSA account to help pay for the cost of your medication. Check with your insurance provider if you have questions about what they will cover.

How do I enter my insurance information as a current member?

If interested in enrolling in a Testosterone or Estrogen+ with insurance membership, let us know! A Care Team member will request for you to complete the insurance forms via Spruce.