Your Top Questions Answered
Hey there, awesome Friday members -
Hope you’re all having an amazing summer so far. Now that we’ve hit 2018’s halfway mark, we wanted to check in and make sure you’re still getting the most out of your Friday health plan.
Over the last seven months, we’ve received great questions from you folks. Questions about your health benefits, doctor visits, generic drugs, and lots more. So, instead of providing tips and reminders about your health plan like we usually do, we’re going to answer your eight most asked questions this year. Here goes:
1) How do I find an in-network doctor or hospital?
Remember, unless you’re having a true medical emergency, staying in network is the only way you’re covered under your plan.
2) My individual health plan includes three free doctor visits. Is the annual wellness exam one of those three visits?
You have three free primary doctor visits AND an annual wellness exam (for a total of four free visits)! Be sure to take advantage of them as we approach the second half of the year. These do not carry over to 2021.
*Individual health plans only. Not available on the Bronze HSA plan.
3) I’m feeling sick but don’t want to wait a week to see the doctor. What are my other options?
Sorry to hear you’re feeling under the weather! But you have a few easy, cost-effective options to get help fast:
Talk to a doctor with Teladoc.
As an extra benefit with every Friday health plan, you can speak to a doctor online or over the phone for a $0 flat fee. Teladoc is the fastest and (in many members’ opinions) the best way to get help for a wide-range of non-emergency illnesses, like sinus problems, respiratory infection, allergies, urinary tract infection, the cold, and flu symptoms.
(This is an added service to your plan, so it does not go toward your deductible.)
Go to an in-network urgent care center
Across the state of Colorado, we have a strong network of conveniently located urgent care centers. Most plans have a $75 co-pay (flat fee) to visit the urgent care*. You can see the full list in this article and find the one that’s closest to you!
*Catastrophic and Bronze HSA must first meet deductible, then urgent care is $0.
4) I received an ‘Explanation of Benefits’ in the mail. I don’t ‘speak insurance’...can you explain what this is?
An Explanation of Benefits (EOB) is a statement you get from your health insurance company after you receive care. It is not a bill. It explains which medical treatments and services you received, the charges for the services, how much of it was covered by your Friday health plan, and how much you may owe.
Always wait for the invoice from your doctor or healthcare facility before paying for services.
How is an Explanation of Benefits (EOB) helpful to me?
An EOB breaks down your healthcare costs in a comprehensive way. It lays out how much your care would have cost without coverage, how much you were actually charged (doctors offer a discount for Friday Health Plans members) and how Friday contributed to the charge based on the type of health plan you have.
Review your EOBs, and if you are surprised or concerned by anything you see, please give us a call for help. We’ll work with you to find out what happened and see if we can re-submit a claim to your provider if things don’t add up.
5) Does my Friday health plan cover birth control?
Put that wallet away. With every Friday health plan, you get $0 access to most kinds of birth control.
Friday’s no cost birth control includes many types of birth control pills, IUDs, the NuvaRing, and Depo Provera — which you can find on the Friday formulary. (If you have questions, please give us a call to make sure your method is $0.)
Quick note: When making an appointment with your OBGYN or primary care doctor to discuss birth control options, be sure to ask if they prescribe birth control. Not all physicians’ offices do.
6) What should I do if I have a medical emergency? If I go to a hospital that’s out of network, will I be responsible for the full cost?
If you have a true medical emergency, go to the closest hospital STAT (regardless of whether the hospital is in-network or not).
Serious or life-threatening injuries and illnesses that require immediate attention are emergencies. Sore throats and extreme paper cuts are not.
Your insurance will cover this visit if it’s a medical emergency, but you may need to pay your portion of the bill to meet your deductible depending on which plan you have, and how much you’ve used your plan this year.
7) Do I need a referral to see a medical specialist?
You do not need a referral from your primary care doctor to see a medical specialist, like an orthopedist, physical therapist, or heart specialist. However, remember you MUST see a specialist who is in the Friday Health Plans network, otherwise you won’t be covered. Search for a convenient, in-network specialist using our provider search.
8) How do I search Friday’s generic ACA preventive drug list? Where can I find the preferred generic drug list?
With every Friday health plan, you get access to generic Affordable Care Act (ACA) preventive drugs, including birth control. You can see that list here.
- Hepatitis A
- Hepatitis B
- Herpes Zoster
- Human Papillomavirus (HPV)
- Influenza (flu shot)
- Varicella (Chickenpox)
If there’s a question you have that we didn’t answer here, please email our Friday Care Crew at firstname.lastname@example.org. We’d be happy to help!