Friday Health Plans of Colorado

Friday Health Plans of Colorado
Friday Health Plans of Colorado Logo

Friday Health Plans is a Colorado-based health insurance provider that currently operates in five states: Colorado, North Carolina, Georgia, Nevada, and Oklahoma.

In Colorado, Friday Health Plans concentrates their offerings on Affordable Care Act-qualified major medical insurance plans, which are offered here via the Connect For Health Colorado online exchange.

Friday Health Plans are available in three basic ACA-qualified “tiers:” Bronze, Silver, and Gold. Each of these plan types is eligible for a “Obamacare” subsidy to help make your health insurance plan more affordable.

The company also offers a “catastrophic” plan with more limited benefits, designed for people ages 29 and younger and in good health.

Friday Health’s ACA-qualified plans (not the catastrophic-only plan) feature popular benefits including full zero-dollar coverage for primary care visits, thousands of preferred generic drugs available at no cost, and urgent care visits for an affordable co-pay of $75 – all without having to meet a deductible first. 

Friday Health Plans Available in Colorado

Catastrophic Plan from Friday Health Plans of Colorado

The catastrophic option from Friday Health Plans of Colorado is a no-frills, just-the-basics policy expressly designed for people age 29 and under.

Premiums are low, but coverages are limited for healthcare services other than catastrophic illnesses and injuries.

However, plan members still have access to an annual wellness visit with their primary care doctor, preventative services, up to three primary care doctor visits, and access to certain generic preventative drugs with zero out-of-pocket costs, such as birth control pills. 

Colorado Bronze BasicFriday Health Plans of Colorado Bronze icon

The Bronze Basic is one step up in coverage from the Catastrophic plan;. If you are age 30 and over, or if you want a somewhat broader array of coverages and protections, and you can afford to pay several thousand dollars out of pocket in the event of a medical emergency, the Bronze Basic plan from Friday Health may be a good option.

This plan is best for people in good health who rarely visit a doctor.

In the Bronze Basic plan, you should expect to pay about 40% of your healthcare costs out of pocket, after you meet your annual deductible. However, your out-of-pocket total costs for the year – not including premiums – are capped at your plan’s out-of-pocket limit for the year, which varies by plan.

Your Bronze Basic plan includes a free annual wellness visit, free unlimited telemedicine visits via Teladoc, and zero cost prescription drugs after you meet your deductible for the year. 

Bronze basic is also available as a high-deductible health plan HDHP), which may qualify you to save thousands in combined taxes and healthcare costs by making pre-tax deductions to a Health Savings Account. 

Friday Health Plans of Colorado Silver iconColorado Silver

With the Silver-tier plan from Friday Health Colorado, premiums are a little higher compared to the Bronze Basic plan. But you get a lot more protection against unexpected medical bills. This plan is designed for people who expect to see their doctors or consume some healthcare during the year.

After you meet your plan’s annual deductible, which you can select, You can expect to pay about 30% of your healthcare costs for the year. The plan will pick up the remaining 70%.

However, once you meet your plan’s out-of-pocket maximum for your plan for the year, Friday Health will pick up 100% of costs beyond that cap.

The Silver Plan includes a free annual wellness visit, unlimited in-network primary care and mental health visits, free access to generic prescription drugs, and free virtual telemedicine visits via Teladoc.

Friday Health’s Silver plan is also available as a high-deductible health plan HDHP), which may qualify you to save thousands in combined taxes and healthcare costs by making pre-tax deductions to a Health Savings Account. 

Colorado Gold 

Friday Health Plans of Colorado Gold iconFriday Health’s Gold-level plans are a low-deductible solution that’s designed for people who use a lot of health care during the year, have a lot of doctor’s visits and other appointments, and who want to pay a predictable premium every month, in exchange for more protection against high health care costs.

After you meet your low deductible you can expect to pay about 80% of your covered health care costs, up to your plan’s annual out-of-pocket limit. After that, your plan will cover 100% of your costs for the rest of the year.

Premiums will be higher than the Bronze and Silver plans. But if you expect to use your insurance a lot, you should definitely consider the Friday Health Gold Plan

  • A 0$ annual wellness visit
  • Unlimited free in-network primary care visits
  • Unlimited free in-network mental health visits
  • $0 generic prescription drugs
  • $0 Teladoc visits
As mentioned earlier, the Bronze Basic plan has an HSA version. A health-savings account is a great idea if you want to save money for medical costs in the future. It will build interest, and you can use it tax-free to pay medical bills (that qualify).

Friday Health Plans of Colorado Mental Health Benefits

Friday Health Plans has some of the most robust benefits for mental health care available in Colorado. With certain plans, members enjoy free unlimited counseling visits with licensed mental health professionals. That is, with these plans, there are zero costs out of pocket for counseling visits, even before you meet your deductible.

All other mental health services not covered with a zero copay are considered specialist visits. That means your out-of-pocket costs are counted toward your deductible for the year. This includes any visits where medications are prescribed.

Friday Health Plans of Colorado Prescription Drug Benefits

Friday Health Plans of Colorado has partnered with Capital Rx to provide plan members with prescription drug benefits.

With Friday’s Bronze, Silver, and Gold plans (not Bronze HSA or Catastrophic), preferred generic drugs are available at no out-of-pocket cost to plan members. 

Capital Rx also offers the free Capital Rx Advantage card, a discount card that enables cardholders to save up to 90% on prescription drugs at 65,000 participating pharmacies nationwide. . 

Primary Care Visits 

Many Friday Health plans provide unlimited free visits with your primary care physician. However, you may have some charges if your doctor has tests done or provides certain medical procedures. These would count toward your plan deductible. 

Telehealth Benefits

With many Friday Health Plans, members enjoy free unlimited virtual access to board-certified physicians 24/7 via Friday Health’s Teladoc program.

Urgent Care Benefits

Colorado plan members have access to urgent care services from in-network providers, usually for a flat fee of $70 to $80 for most plans. This is the case for Gold, Silver, and most Bronze tier plans.

Can’t make it to an urgent care clinic? Friday Health also makes  same-day urgent care “house calls” available via Dispatch Health.

Vaccinations

Vaccinations are available via your primary care physician’s office or at any of hundreds of  participating pharmacies around Colorado.

 

Frequently Asked Questions About Friday Health Plans of Colorado

 

FAQ iconDo Friday Health Colorado plans qualify for a subsidy?

Yes, the Bronze, Silver, and Gold-tier plans all potentially qualify for a subsidy, which may vary based on your income and the number of people in your family. Individuals who earn less than about $50,000 annually qualify, as does a family of four earning less than about $103,000.

To see if you qualify for an Affordable Care Act subsidy, contact a ColoHealth personal benefits manager.

Your PBM can also handle your enrollment via the Connect For Health Colorado exchange at no cost to you.

FAQ iconDoes Friday Health require me to use a care network?

Yes, Friday Health Plans are health maintenance organizations (HMOs) and preferred provider organizations (PPOs). Both types of plans limit costs by contracting with doctors and other care providers who agree to provide members with discounts, in exchange for a steady flow of referrals from the plan.

Friday Health plans will cover emergency care from any qualified provider. But you must seek non-emergency care from in-network providers to receive full benefits.

FAQ iconI missed Open Enrollment for Obamacare. Can I still get a Friday Health Plan in Colorado?

In some circumstances, yes, it is possible to enroll in a Friday Health Plan even if you missed the November 1st through January 15th Open Enrollment Period that applies in most of the U.S., including Colorado.

First, beginning January 1st, 2022, individuals and families with incomes below 150% of the federal poverty line, and who qualify for a premium tax credit (subsidy) that will cover the cost of the benchmark plan. can enroll in an ACA-qualified health insurance plan at any time during the year.

Second, you may qualify for a 60-day special enrollment period if you have a qualifying life event.

These may include loss of group coverage, marriage, divorce, death of a spouse, birth or adoption of a child, relocation to an area not served by your previous plan, change in citizenship status, release from incarceration, or aging out of your parents’ health insurance plan.

FAQ iconI don’t qualify for a special enrollment period. Do I have any other options to get health coverage?

If neither of these circumstances apply, you can find an employers’ group plan to join. Otherwise, you’ll probably have to wait until the next Open Enrollment period rolls around.

Another option is to join a healthsharing plan. Health sharing is an affordable alternative to traditional health insurance in which a group of people form a voluntary association via a non-profit health sharing ministry organization to share each other’s medical expenses.

These plans can help protect you from large unexpected healthcare expenses. They are available for about half the cost of the monthly premium of an unsubsidized policy. And there’s no open enrollment period; You can join a healthsharing plan at any time during the year.

The disadvantages are that healthsharing plans don’t qualify for a premium tax credit subsidy under the Affordable Care Act. Also, if you have pre-existing conditions, health sharing plans generally impose a waiting period before costs to treat those conditions become fully shareable.

To find out more about healthsharing plans available in Colorado, contact a ColoHealth personal benefits manager!

HEALTH INSURANCE INFORMATION

  • Plans approved and authorized under the Affordable Care Act
  • Covers Pre-Existing conditions
  • Low cost subsidized plans available to those earning
    < 400% of the federal poverty level
  • Unlimited lifetime benefits
  • Available during open enrollment (November 1 – January 15), or if you qualify for a Special Enrollment Period

Learn More About Colorado Health Insurance Plans

HEALTH COST-SHARING INFORMATION

  • Not health insurance, but a way for like-minded individuals to share medical expenses
  • Waiting periods on pre-existing conditions
  • May exclude sharing for certain conditions or activities
  • Enroll any time
  • Much lower monthly cost than unsubsidized health insurance

Learn More About Colorado Healthshares Plans

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