AmeriHealth Caritas Next offers coverage to ex-Friday Health Plans members in North Carolina

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来源: FierceHealthcare

If the approximately 39,000 members of Friday Health Plans in North Carolina switch to an AmeriHealth Caritas Next plan, the insurer said it will honor the payments they have already made toward their 2023 plan year deductibles and out-of-pocket caps.

As Friday Health Plans dies in each of the seven states in which it once operated in, insurance officials in those states voiced concerned about two issues: providers still caring for Friday Health Plan members (guaranty funds have been promised to cover costs) and the members finding new coverage without being penalized by paying another deductible and more out-of-pocket costs.

The approximately 39,000 Friday Health Plans members in North Carolina insurance received good news yesterday when AmeriHealth Caritas Next announced that the company is willing to take on those former Friday members in a special enrollment period that ends Oct. 30. AmeriHealth Caritas said it will honor deductibles and out-of-pocket payments that Friday members have already made this year. Friday Health Plans sold insurance on the Affordable Care marketplace.

AmeriHealth Caritas Next President Loretta Lenko said in a press release that “losing one’s health insurance coverage unexpectedly can cause enough stress on its own. We’re taking this step to remove at least one of the stress factors that Friday Health Plans members are facing at this time. This action demonstrates our commitment to helping those most in need navigate life’s challenges.”

North Carolina insurance officials placed Friday Health Plans into receivership in June. At the time, Jayson Tyson, a spokesperson for the North Carolina Department of Insurance, told Fierce Healthcare that the state moved forward “judiciously and at a deliberate pace” in taking its action to establish a system whereby Friday’s policyholders will not have a gap in coverage.

“We’re going to continue to try to protect the policyholders,” Tyson said. “We want to give them enough time to find other coverage.”

According to the AmeriHealth Caritas Next press release, its plans are available to Friday Health Plans members living in the following counties: Alexander, Avery, Buncombe, Burke, Caldwell, Catawba, Cherokee, Clay, Graham, Guilford, Haywood, Henderson, Iredell, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Randolph, Rockingham, Rutherford, Swain, Transylvania, Watauga and Yancey.

AmeriHealth Caritas Next plans are offered in 35 North Carolina counties.

“Enrollees can choose from four gold-level plans, seven silver-level plans, and eight bronze-level plans offered by AmeriHealth Caritas Next,” according to the press release. “Each plan has varying premiums, deductibles and co-payments. Some plans are available with low or zero premiums after federal government subsidies. All plans include access to a comprehensive network of physicians, hospitals and other health care services.”

Ari Gottlieb, a principal at A2 Strategy Group and a nationally known healthcare strategist who’s closely followed the insurtech industry, told Fierce Healthcare last week that in every state that’s liquidated Friday Health Plans, “there are some issues with providers taking Friday members. What we’re seeing is state departments of insurance going out and saying to providers ‘Look, we will make you all of these guaranty associations that will step in and help, so continue to see these members.’ It’ll be a fight. I think that some providers may not want to serve these members, but they haven’t a choice.”

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