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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
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Check your plan's materials: Health plans must disclose if they are grandfathered in all materials describing plan benefits. They must offer contact information.
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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.
I posted this on another thread but its obvious it bears repeating,
