9 November 2023
After the state of Nevada liquidated her health insurer in July, cancer patient Jean Fenolio faced uncertainty in finding new health insurance and the timing of when she could receive a double mastectomy.
Fenolio, 46, was worried about how she would pay for surgery given she had already reached her out-of-pocket maximum for the year with her previous insurer, Friday Health Plans, and her previous payments would not carry over to a new insurer.
However, with the help of the state’s insurance marketplace, Nevada Health Link, Fenolio was able to sign up for new insurance and get coverage for her surgery. Community donations through a GoFundMe page offset the other surgery costs, special surgical bras, shirts for after the surgery and medications.
“That was fantastic,” Fenolio said in a recent interview about the financial support from the community. “It has cost quite a bit with the new insurance and trying to figure everything out and the co-pays … with me not being able to go to work.”
Fenolio was one of more than 2,670 Nevadans who lost their Friday Health Plans coverage after state regulators liquidated the company due to its “hazardous financial conditions” and an inability to repay debts or achieve solvency. The company also faces liquidation in Colorado and Texas, as well as receivership in Georgia, Oklahoma and North Carolina.
As of Nov. 1, about 74 percent (1,988 people) had reenrolled with a new insurer through the state’s health insurance marketplace. Most reenrollments occurred during a special enrollment period the exchange opened up before the state terminated Friday Health Plans at the end of October.
Russell Cook, executive director of the Silver State Health Insurance Exchange, said despite the data indicating that 685 people have entirely lost their health care coverage, a “significant number” had enrolled themselves in a new insurance program outside the exchange, sometimes with help from the Nevada Health Link team.
In an email, Cook said many of those individuals lived in rural counties and had limited insurance options on the exchange after Friday left the marketplace.
He noted that the exchange worked directly with Fenolio throughout August to resolve a Medicaid eligibility issue and get her enrolled in an Aetna health plan with coverage starting Sept. 1.
Cook added that though the special enrollment period expired at the end of October, those affected by the liquidation of Friday Health Plans can still enroll in 2023 coverage if they contact Nevada Health Link’s call center and request an exemption.
Left: Jean Fenolio rings a bell after completing chemotherapy on Aug. 29, 2023. Right: a certificate of completion for finishing chemotherapy treatment. (Photos courtesy of Pete Atkins)
Though her surgery went well and healing is moving along, Fenolio said doctors found cancer cells in a lymph node, and she will need to have more radiation treatment in the future.
“Every time I think I see a light at the end of the tunnel, something else happens,” Fenolio said.
She added that her new insurer, Aetna, has declined some of the claims, but they covered her surgery, which was the biggest hurdle.
But she’s since received bills that Friday Health Plans did not cover, including some dated as far back as April.
“A lot of them aren’t super expensive, so I’m just kind of paying them as I go,” Fenolio said. “It just makes my life a little bit easier to just know that they’re paid and not fight it and not hassle with it … because that’s one less thing I have to worry about.”
Officials with the Nevada Division of Insurance and the Silver State Health Insurance Exchange said former Friday Health Plans clients with open claims or payment issues should contact the special deputy receiver via email, who was appointed to ensure all applicable claims are paid.
They also noted that Nevada has a Guaranty Association in place that serves as a safety net so Nevada consumers do not have to pay claims from their own pockets.
In the meantime, Fenolio said she and her longtime partner, Pete Atkins, are taking life one day at a time.
“We’re doing OK,” Fenolio said. “I just sit around and try to heal.”