March 29 2018

YOUR Questions Answered

Health insurance can be pretty darn tricky. And so, not so surprisingly, our Colorado-based customer service team gets some great questions from you folks each week.

Long story short, we figured many of you would benefit from seeing the answers to the most common questions we get each month. So that’s what we’re doing in this post.

We work hard to make health insurance easy, but if you get confused by some of the terminology, check out our glossary of terms here.

If there’s a question you have that we didn’t answer below, please give us a call at: 800-475-8466. We’d be happy to help!

What’s an Explanation of Benefits (EOB)?

An Explanation of Benefits (EOB) is a statement you get from your health insurance company after you receive healthcare. It is not a bill, but it explains which medical treatments and services you received, how much of it was covered by your Friday health plan, and how much you may owe.

Remember, an EOB shows what you may owe your provider, not your health insurance company. Always wait for the invoice from your doctor or healthcare facility before paying for services.

How do I see my EOB?

You can view your EOB on the Friday Health Plans member portal. It’s a handy tool to track your claims all in one place. If you have trouble registering for your portal or understanding your claims, please reach out to our customer service team. We’re happy to help!  

How is an 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.

It also contains good-to-know information about your health plan’s deductible, the services you received, the date the services were performed, and the dates the services were covered.

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.

Big note: You do not pay anything upon receiving your EOB. In fact, in some cases you may owe nothing (if you already paid your copay at the doctor’s office, for example). Either way, you’ll receive a bill directly from your provider and that is when you pay.

Does my Friday health plan cover maternity?

First off all, congratulations! With so much to be excited about, Friday has you covered throughout the whole process with your doctors and delivery team.

To start, be sure to pick an OBGYN that will deliver your baby at an in-network hospital. Your Friday health plan will cover the standard health tests, supplements, exams, and hospital delivery and stay.

Don’t forget to give us a call when your bundle of joy arrives so they can join your Friday health plan and receive all the health benefits for new babies.

Are physical therapy visits covered with my Friday health plan?

Yep. Physical therapists are specialists and are covered the same way. While you do not need a referral from your primary care doctor to see a physical therapist, you must see a PT who is in the Friday Health Plans network, otherwise you won’t be covered.

Search for a convenient, in-network physical therapist using our provider search.

Please also keep in mind that you will be required to pay your plan’s copay, or the flat fee, for your physical therapy visit. This copay varies based on your specific Friday health plan, so be sure to review your plan details on your member portal before your visit.

How do I schedule my free annual eye exam?

Every Friday health plan includes an annual WellVision Exam. It’s super easy to schedule. Simply visit vsp.com, find a close and convenient eye doctor (they’re all in-network), and schedule an appointment. It’s that easy.

In addition to standard visual acuity tests, during the exam your eye doctor will look for eye muscle imbalance, vision disorders, and eye disease that could potentially cause future problems. Based on the results, your eye doc may recommend further testing.

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.

All plans also have access to a wide-range of vaccines to help keep you in ship-shape. You can get these done at your primary care doc’s office or through a local, convenient vaccine provider:

With Friday’s individual Bronze, Silver, and Gold plans (not Bronze HSA), preferred generic drugs are also $0. You can see that list right here.

As always, if you have any questions about your plan, benefits, or services, please call our friendly customer service team at: 800-475-8466 or custsrv@fridayhealthplans.com 

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