As people choose new coverage, they need to be careful about plans that offer limited benefits

COLORADO — Members of defunct health insurance provider Friday Health have until the end of this month to choose a new insurance provider to remain insured.

The Colorado Division of Insurance (DOI) has filed with the Denver District Court to liquidate the failed company so consumers need to act. In mid-July, due to the financial instability of Friday Health and growing concerns about healthcare providers refusing to treat Friday enrollees, the DOI forced the liquidation to protect the public and ensure the smooth operation of open enrollment for 2024. An estimated 30,000 Colorado consumers need to find new insurance. 

 As the Special Enrollment Period (SEP) for Friday Health members to choose new coverage for the remainder of 2023 continues, the Colorado Division of Insurance (DOI) is providing updated information about other health insurance companies honoring the deductibles and out-of-pocket maximums that Friday Health members have already accumulated for 2023. When choosing new insurance consumers should note most providers will not honor Friday Health deductibles, according to DOI. Most consumers will lose the amount accrued to meet those deductibles when choosing a new company.

Companies such as Denver Health and Kaiser will honor the accumulations.

Now is the Time to Enroll in New Coverage

As of Aug. 8, Friday Health members have only 24 more days to choose a new health insurance plan that will start on Sept. 1 and provide coverage for the remainder of the year. While the SEP will last until Oct. 31, Friday members who enroll in a new plan after Aug. 31 will have their coverage start on the first of the month after enrolling in that new plan — for example, someone enrolling on Sept. 2, will have their new plan start on Oct. 1.

The DOI offers this advice: Avoid Limited Benefit Plans

During this special enrollment period, the DOI wants to caution Coloradans about low-quality, limited coverage health insurance or health insurance-like products that do not meet the requirements of the Affordable Care Act (ACA). There are people and groups that will try to lure unsuspecting Friday members into buying short-term plans, trade association plans, health care sharing ministries or other limited plans. Such plans can leave consumers stuck with huge medical bills from doctors and hospitals, as the plans deny and limit health care coverage in some or all of the ways below. 

• Limiting coverage regarding the treatment for pre-existing conditions
• Limiting prescription coverage
• Limiting coverage for hospitalizations and emergency rooms
• Limited or no coverage for mental health-behavioral health treatment
• Limiting coverage for outpatient-same-day surgery

What are the red flags that could indicate the health plan you’re looking at may fall short of the ACA requirements?

• High-pressure sales tactics
• Being told that the coverage is “just as good as the ACA.”
• Use of words such as “limited benefit plan” or “supplement plan.”
• Continued calls, emails, texts and even unannounced visits to your home by someone trying to close the sale. These may cross over to the level of harassment.

How can you avoid buying this limited health coverage? Before you buy, ask for the plan’s details in writing, details such as how would the coverage work when visiting a doctor for tests and follow-up care, or how would the plan cover a hospital stay with testing, surgery and specialists. Know that you have the right to ask questions and get this information.

While all the changes surrounding Friday Health can be challenging and stressful, the Division does not want to see people put into peril by choosing such arrangements. Friday members who believe they are being pressured into these limited benefit plans can contact the DOI Consumer Services Team at 303-894-7490.