As people choose new coverage, they need to be careful about plans that offer limited benefits.
DENVER - 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.
Denver Health has agreed to honor these accumulations for Friday Health members that select a Denver Health plan for the remainder of 2023. Denver Health joins Kaiser as the two Colorado insurance companies honoring these accumulators for Friday members. This information has also been updated in the Division’s list of frequently asked questions (FAQs) for consumers (English / en Español).
Now is the Time to Enroll in New Coverage
As of today, August 3, Friday Health members have only 29 more days to choose a new health insurance plan that will start on September 1 and provide coverage for the remainder of the year. While the SEP will last until October 31, Friday members who enroll in a new plan after August 31 will have their coverage start on the first of the month after enrolling in that new plan - for example, someone enrolling on September 2, will have their new plan start on October 1.
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 of 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 - 303-894-7490 / DORA_Insurance@state.co.us.
About the Division of Insurance:
The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit doi.colorado.gov for more information or call 303-894-7499 / toll free 800-930-3745.
DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 800-886-7675.