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Barack Obama

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DevonRex

(22,541 posts)
Mon Sep 23, 2013, 08:25 PM Sep 2013

Find Out If Your Health Care Policy Is A Grandfathered Plan. IMPORTANT!!! [View all]

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.
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