ComplaintsforFriday Health Plans

• Initial Complaint

  12/21/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I had coverage up until 8/01/2023 and it is stated on the termination letter they provided in my portal. They covered all but two claims on 6/5/2023 and 6/29/2023 and have been giving me the run around. Today the agent said they have recently updated my records saying I never had coverage in 2023 and she agreed that it was crazy and clearly false. Then she proceeds to agree with the false information and told me she was going to resubmit my covered claims to be reversed and denied!! I have never in my life experienced this level of jankyness and fraud from a company! I am about to get the lawyer involved and file a suit if they don't quit the shenanigans and cover those last two claims or provide a letter of early termination dated 6/,01/2023 or 5/31/2023 which is what a previous agent told me as to why these two claims were not covered.

• Initial Complaint

  10/25/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I called them telling them about a transaction and told them 10 times I didn't want another card they was very rude and wouldn't listen to me interrupting me and still did what they wanted I talked to supervisor and she just said I'd have to deal with it and wait for another card I'm done with the Friday card unprofessional and don't listen to you

• Initial Complaint

  07/28/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I enrolled in a Friday Health insurance plan through healthcare.gov in January 2023. Shortly after I paid a year's worth of premiums in advance. In June 2023, I received notification that Friday Health was pulling out of ** and closing down and that a new health care plan provider would need to be selected after August. I contacted the company on July 7 to request a refund of my remaining balance (for premiums I paid in advance). I also informed them that my new insurance would be effective August 1. The customer service representative requested the refund and sent me written confirmation of the request. On July 17, I contacted the company again about my refund. The response was that it would take up to 45 days for the refund to be processed. So, it is now July 28, and I still have not received my refund of $56.44, the surplus balance on my account after premiums were paid through July 31. I want my money before the company shuts down. It didn't take them 45 days to deduct the payment. It's ridiculous that they estimate 45 days to return my unused money. I also want the full $56.44 because I verbally terminated insurance coverage after July 31. My new policy becomes effective August 1, so the company should not deduct August's premium from my refund.

  Business response

  08/01/2023

  Good afternoon, 

  I understand your frustrations. However, Friday Health Plans has always had a 30 - 45 day refund processing. Now with the closing down of Friday Health Plans, funds have to be approved before we are able to refund any money. Your refund is with the billing department and funds should be released once it is approved. If you have any further questions, please reach out to ********* at *************************************************************** or the number on the back of your card. 

  Thank you,

  *********************** - Director of Appeals and Grievances

  Customer response

  08/02/2023

   
  Complaint: 20390371
  
  I am rejecting this response because:
  

  This sounds like the exact same response I received the last time I emailed about my refund status. My refund has been processing for weeks now. How long does the approval take? This is ridiculous. You need approval to return money that doesn't belong to you?! It's going on 4 weeks now. It takes a few seconds to hit a button on the computer. That's how long it took you to deduct money from my bank account-- seconds. I expect my refund this week or I'm disputing the charge with my bank as a fraudulant charge. That's exactly what it is. You took money from my bank account for services you never intended to provide, and refuse to return my money. It is simple as that. 

  Regards,
  *******************************

• Initial Complaint

  07/13/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have filed 8 separate claims in the past year and have not received payment for any of them. There customer service just states to resubmit everytime. I've done that and then call back and they still say they don't have anything. After 90 days they state its past the timely filing deadline and reject the claims. They are not paying what they are contracted to pay for and keep delaying until their deadline passing giving them a loop hole to get out of payment.

  Business response

  07/31/2023

  Good morning,

  In order to assist on this BBB, I will need to get more information. I need to know the member ID number, date of birth and if there is proof of timely filing. If everything can be sent over to ********************************** we will help get it taken care of as soon as we can. 

  Thank you, 

  ***********************

• Initial Complaint

  05/23/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I contacted Friday Health Plan to get a list of providers for my annual mammogram.I was emailed a list of providers.I contacted providers on the list.Your providers gave me the number for ********************-They took my insurance info and assured me they accept all insurance-both over the phone and at the facility. I explicitly asked!!!!Now, I'm being billed for the entire mammogram. Friday Health Plans should accept responsibility for providing their members with current facilities. This seems to be a pattern with them and people are hurting with getting huge medical bills they were told would be covered.

• Initial Complaint

  04/24/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I was told by a friday health care representative via phone call that my preventative test would be covered at 100% in advance of the test. I had the ultrasound on 7/27/2022 and submitted the claim. The company did not respond for several months despite frequent emails and letters regarding the claim. According to their guidelines, they're required to process, accept or deny a claim within 30 days of receiving it. They then denied the claim stating it was out of network, a fact that was left out in our initial call I made to ensure it would be covered by friday and I would be reimbursed. I requested a month ago to have their external review team to reprocess this one and only claim I've submitted and I still haven't heard back from the appeals coordinator. The reimbursement is only for $139, but still we're low income. It's unethical and illegal what this company has done. Insurance companies deny most claims in order to frustrate patients so they give up trying to be reimbursed. Thank you.

• Initial Complaint

  04/17/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I have contacted the Friday Health ***************** several times this year since February because we are in need of a 1095A to be able and do our taxes correctly. Every time I call they swear that it will be sent and each and every time I received nothing. Last time before today April 14th, I had been assured that they would give me the info by phone if the form wasn't sent. Tried doing taxes today but when I called Friday they couldn't give the info by phone, now my taxes are going to be late because the 1095A form is not sent. I believe this is just retaliation for filing a complaint with the ***** ********** of ********* because they had 2 different insurance plans under my name, ******************************* and ********************************** which is the right plan and without authority just to charge the government. All I ask is for them to send my needed 1095A form and stop retaliating against me, if it was their employees falsifying plans to customers to get commissions from them.

• Initial Complaint

  04/14/2023

  Complaint Type:

  Order Issues

  Status:

  Unanswered

  More info

  I stopped making payments to Friday Health Plans last year when I got a new health insurance policy through a new employment position. Because I did not cancel immediately, Friday Health Plans kept billing me even though I was no longer paying. After much time on the phone and in emails with one of their representatives, I was told that the matter was settled and that I owed nothing.Then today I received a bill from them for a "previous balance" of $331.53.

• Initial Complaint

  04/14/2023

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  I terminated my plan (ID 200100894-01) in January to take effect at the end of January after they had raised the premiums for the same plan from the year before by 50%. I had a credit balance on my account for $1356.63 for prepaying. I contacted the company in February when they sent me the next month's statement showing the credit balance and they said they would send me a check within 2 weeks. It's now the middle of April and I still have not received the check. They are quick to cancel policies or withhold coverage when a customer doesn't pay but for some reason can't return customer funds in a timely manner (It has been 90 days since they knew the plan would be cancelled and 60 days since they sent out the last invoice and I made the request). When I lived in NY, actions like this could be taken to small claims court where the recipient could receive treble the amount in damages (specifically with regards to holding on to security deposits). As bank interest and treasury bills are up to 5% now, this has amounted to theft of **** cents per day which is about $17 and counting.

• Initial Complaint

  02/15/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I called, googled and called the ********* Agent - All ********* and asked if Novant Health was covered under Friday *********. All parties said yes. One in ************ one in **********. I made the apt for 2/14/2022 at 8:45am at Greenhouse Novant Health for a mammogram. I was charged 200$. I called Allstate Insurnace and spoke to ****. He said the insurance must have changed since I made to appointment. I was charged 200$ for the mammogram. Tried calling Friday customer service only to be interrupted.

  Business response

  02/16/2023

  Friday Health Plans will process this Member's complaint through the internal Grievance process and will provide formal written response to the Member following further review of the Member's account. The determination letter will be sent to the Member within the 30 day timeline for this process.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩