Grandfathered Health Plans

[emdee]

We received our 2011 insurance package from my husband's work. I immediately searched out the no-cost preventative care procedures to make sure it was zero. It was not. Reading further, I see that the company considers its plans to be Grandfathered Health Plans which do not fall under the provisions of the new health care law. What?

"Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventative health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits."

I should not have been surprised.
:mad:

[riderinthestorm]

1. Who could have foreseen that insurance companies would find and exploit another loophole?

Anyone know if there really IS some kind of loophole that allows insurance companies to claim this kind of "grandfather" exemption?

What company is this? I'm wondering if its one of the largest insurance companies (that I presume was in on writing this legislation and made sure this provision was in there....)

[emdee]

2. Blue Cross Blue Shield

It is a corporate health care plan underwritten by BCBS.

It has included children to the age of 26 and it also has dropped preexisting conditions for kids.

This is very strange to me: "New for 2011, over-the-counter drugs or medicines (except insulin) are reimbursable only if patient receives a prescription from a physician or other health care provider as allowed under state law." This is under the Flexible Spending Account, which we have not used previously.

[riderinthestorm]

3. BCBS is one of the biggest obviously.

And they are "grandfathered?" So they don't have to participate in HCR???

Wowza! They just get to voluntarily participate in some aspects of the reform (cough) that they decide they want to participate in?

[emdee]

4. We just got the booklet yesterday

I plan to look into it more but doubt I'll be able to change anything. I'm sure they have their i's dotted. Premiums went up, of course.

[emdee]

5. Healthreform.gov

http://www.healthreform.gov/newsroom/keeping_the_health_plan_you_have.html
http://www.healthreform.gov/about/grandfathering.html


"Most of the 133 million Americans with employer-sponsored health insurance through large employers will maintain the coverage they have today. Large employer-based plans already offer most of the comprehensive benefits and consumer protections that the Affordable Care Act will provide to all Americans this year – such as preventing lifetime limits on coverage – and in the future."

Evidently, this is part of the "you can keep what you have" claim.

[riderinthestorm]

6. This is going to drop off my DU page and thought it worth another try

See if anyone else had heard of this "grandfathered" exclusion for BCBS, that they don't have to follow the new provisions of HCR.

A Sunday morning kick for one more go around.