WHAT IF I HAVE A GRANDFATHERED HEALTH INSURANCE PLAN?

If you have a grandfathered plan, you have the option to switch to a Marketplace plan and enjoy the rights and protections that other plans have to offer. Grandfathered plans are group or individual health plans that were created or purchased on or before March 23, 2010.  These plans are exempted from many changes required under the Affordable Care Act.

Under ObamaCare, all health plans must:

  • End lifetime limits on coverage.
  • End arbitrary cancellations of health coverage.
  • Cover adult children up to age 26.
  • Provide a Summary of Benefits and Coverage (SBC), a short, easy-to-understand summary of what a plan covers and costs.
  • Hold insurance companies accountable to spend your premiums on health care, not administrative costs and bonuses.

 

Grandfathered plans don’t have to:

  • Cover preventive care for free
  • Guarantee your right to appeal
  • Protect your choice of doctors and access to emergency care
  • Be held accountable through Rate Review for excessive premium increases

 

In addition to the above, grandfathered individual health insurance plans don’t have to:

  • End yearly limits on coverage
  • Cover you if you have a pre-existing health condition

 

Some grandfathered plans offer protections they’re not required to. To find out if your plan is grandfathered, check your plan’s materials and/or check with your employer or your health plan’s benefits administrator.

 

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