Some Colorado doctors have refused to see patients covered by the nearly defunct insurer Friday Health, but state officials are trying to reassure them they will get paid.
The parent company Friday Health Plans, which is based in Alamosa, experienced a rapid decline this year as multiple states announced they wouldn’t allow the company to sell any more policies or had placed it into receivership, meaning they took control of any assets in their own state’s subsidiary to ensure claims were paid.
Friday, which sold insurance in seven states including Colorado, won’t be available anywhere in 2024.
The Colorado Division of Insurance said the Colorado-specific branch of the company has enough funds to continue paying claims this year. If claims were to exceed its funds, however, the state’s Life and Health Insurance Protection Association would pay out up to $500,000 for each Friday member’s care. The association collects fees from member companies, and state law was changed earlier this year to make Friday a member, allowing it to pay out if the company folded.
About 30,000 people in Colorado purchased insurance from Friday on the individual market for 2023.
Laura Will, of Evergreen, said she was surprised when her doctor canceled a hip surgery she was expecting to undergo after months of preparation, citing uncertainty about her Friday insurance. It would likely take months more to make an appointment with a different orthopedic surgeon, she said, and switching insurance plans isn’t an option until November.
“It’s just a little frustrating,” she told The Denver Post. “Someone who goes and gets a plan because their doctor is in-network, and their doctor decides they don’t want to be in that network anymore, they’re stuck with that plan.”
It’s not clear how many people are in a similar situation, but the Colorado Division of Insurance confirmed it was reaching out to providers to encourage them to keep accepting Friday plans.
The state has taken over Friday’s assets in Colorado and is using them to pay claims through a contractor, said Vince Plymell, spokesman for the Division of Insurance. It’s likely that doctors were confused about the process, he said.
“We have moved the company into rehabilitation (with the state taking control) to not only make sure that members’ coverage continues, but that doctors, hospitals and other health care providers continue to be paid,” he said.
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