Find Out If Your Health Care Policy Is A Grandfathered Plan. IMPORTANT!!!

[DevonRex]

https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/
If you are covered by a plan that existed March 23, 2010, your plan may be "grandfathered." You may not get some rights and protections that other plans offer.

Grandfathered plans
Grandfathered plans are those that were in existence on March 23, 2010 and have stayed basically the same. But they can enroll people after that date and still maintain their grandfathered status. In other words, even if you joined a grandfathered plan after March 23, 2010, the plan may still be grandfathered. The status depends on when the plan was created, not when you joined it.

How to find out if your plan is grandfathered
Check your plan’s materials: Health plans must disclose if they are grandfathered in all materials describing plan benefits. They must offer contact information.

Check with your employer or your health plan's benefits administrator.

What grandfathered plans do and don't have to cover
Here's a quick look at the consumer protections that do and don't apply to grandfathered plans:

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 (the kind you buy yourself, not the kind you get from an employer) don't have to:

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

Note: Some grandfathered plans offer protections they're not required to. Check with your insurance company or benefits administrator to learn if your grandfathered plan offers the rights and protections listed above.
END***

I added the stars for emphasis. This is very important. If you have a grandfathered plan you will want to enroll in an ACA plan come October 1st. And if you work for a smallish company that provides health insurance, find out about your policy and pass the information along to whoever handles insurance at your office. They may not be aware of this.

If all else fails and you can't get an answer that satisfies you on grandfathered policy or not, I always rely on hrsa.gov. There's a phone number on the site that you can call and I think there's a new one related to ACA now. I just haven't been there since my son has been hospitalized.

He's walking and talking normally now, BTW. Splitting, blinding headaches and shooting pains and numbness down his arms. But he's going to be OK.

I knew I could count on you to get me through this mentally. I just never knew how much your prayers and Reiki and vibes would help him. The female doc who admitted him had tears in her eyes when she peaked in his room and saw him walking. We hugged and cried at the end of the hall. She had thought the scans would show he wasn't there anymore.

So thank you. Thank you.

[NYC_SKP]

1. Thank you, DevonRex.

I hope your son experiences continuing improvement.

[DevonRex]

3. Thanks, skp!

I read the posts in that thread over and over for comfort and to be positive when I was down. And read them to him when he was sleeping and again when he woke up, so he'd know that literally hundreds of people he didn't know were pulling for him in their own ways. So much more powerful than anyone could possibly imagine.

[Cha]

5. Ohhh, that is so poignant, Devon~

[DevonRex]

14. Cha, I'm really

upset right now. As in crying my heart out. It has become obvious with the vitriol that I never should have posted about my son to begin with. I'm horrified.

[Hekate]

15. My God, what happened?!

Never mind -- don't say it here -- I hope whoever the *holes were got tombstoned.

Obviously I missed whatever happened, but I am so sorry. I am so sorry. I'm glad you came to us in the BOG -- know you are loved and that all of us who posted our prayers and good wishes for you and your son are still doing so. We are still here for you.

Hekate

[sheshe2]

2. Thank you Devon for the information on the grandfathered plans.

I work for a large company, I will check none the less.

And Devon, thank you for the update on your son. I am so happy for you all. Despite the headaches and pain, he is alive and will get better.

(((((HUGS)))))

she~

[DevonRex]

4. You're welcome. I didn't know about the grandfathered plans

until someone asked a question in GD and in looking for information I stumbled upon this. Since it drastically limits ACA protections and benefits, I had to post about it.

Thank you for all your well wishes and prayers. They got him through. And me, too. There were times I was afraid to be close to him because I was just in despair. I couldn't let my negative feelings touch him. That's when I pulled out my phone and read the thread. You lifted me up when I couldn't do it myself. And then I could be strong for him again.

[sheshe2]

16. Sorry Devon.

Just seeing your post now.

My dear, I am still new here, less than a year. Days, 17 to be exact after I joined DU. A dearly loved one got married. Later that night he fell from an outside stairway. He nearly died. Actually he was non responsive when the medivac picked him up. I was new, yet one night when his wife posted wedding pictures, it was late and I was in tears. At that point we had no clue if he would ever be the same. I posted on DU, and oh the support I got was amazing. It helped me through the night.

It took months to know the outcome. Yet he is now fine and strong. I was there with you Devon, I am not a mom, yet he is the closest thing that I have to a son. I truly knew what you were going through and I am so very glad that he is well.

Hugs~

[SunSeeker]

6. I have a grandfathered Blue Shield plan here in CA, and get free preventive care.

All my preventative care is now covered 100% with no co-pays; everything ftom flu shots to colonoscopies. I don't know if it's because of CA law or Blue Shield's decision to do the right thing, but they appear to be complying with the ACA.

[DevonRex]

7. Cool. Blue Cross can generally be trusted to do better than

some of the others. As long as you're aware to keep an eye on it from year to year...

[SunSeeker]

8. Oh I am. The State's watching them too.

And the insurance companies know if they pull too many shenanigans, the State may go single payer. But for the votes of a few conservadem state legislators, we almost did.

[IrishAyes]

18. We're on the beginning of the road to single payer anyway.

May take awhile, but the whole country will get there eventually.

[SunSeeker]

19. I agree. nt

[hopemountain]

9. so good to hear your encouraging update

and to read your informative info about grandfathered plans. those corporate healthcare scoundrels got a whiff of what was coming down the pipe with ACA and tried to get around it. but, at least folks have an option to choose on the first. your post is a public service. thank you.

[DevonRex]

11. Your welcome. It never hurts to check. And some GF plans choose

to follow ACA guidelines like sunseeker's Blue Cross above. Even so, sunseeker knows to check for changes every year since they aren't legally obligated to follow it.

My source at HRSA says that *many major insurance companies do choose to follow the guidelines but not all. And yes, you WILL have to check every year upon renewal because they aren't obligated.

[treestar]

10. Good information

I'm going to check again - I think a got a letter about grandfathering.

So glad about your son. May you both stay strong through the healing process and may God or the Flying Spaghetti Monster watch over you!

[DevonRex]

12. Remember if your plan is GFed and follows the guidelines

check the policy every year for changes in case they decide *not to follow one or two or all of them anymore. Forewarned, etc.

It'd be cool if God were the flying spaghetti monster, wouldn't it? I mean, he's a fun monster, right? And who doesn't love spaghetti? And it wouldn't be fattening if God were made of spaghetti. That'd be blasphemy! Pasta for everyone! Down with Olive Garden, though. It'd be my sauces, passed down from generations ago by branches of la famiglia in Firenze e Napoli.

[treestar]

13. I agree! Olive Garden would be like on of those churches

that signs people up for tithes!

The real church would be the family kitchen!

[IrishAyes]

17. Thanks for the great news about your son, and the critical info on grandfathered plans

I have half a mind to pass the latter on via a letter to the local weekly paper, but our state's one of the ones opting out as much and as long as it can. Don't know if it would do any good here at this point.