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 are those that were in existence on March 23, 2010 and haven’t been changed in ways that substantially cut benefits or increase costs for consumers. Insurers must notify consumers with these policies that they have a grandfathered plan.
There are 2 types of grandfathered plans: job-based plans and individual plans (the kind you buy yourself, not through an employer).
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.
Here's a quick look at the consumer protections that do and don't apply to grandfathered plans:
All health plans must:
Grandfathered plans DON'T have to:
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:
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.
Yes. Grandfathered plans count as minimum essential coverage. This means you're considered covered under the health care law.
If you see major changes to your grandfathered job-based health plan's coverage or costs, contact:
Employee Benefits Security Administration, U.S. Department of Labor
Yes. A grandfathered plan can be an individual health insurance plan or a job-based plan. Any plan established before March 23, 2010, has covered at least one person continuously since then, and has met certain other requirements can be considered grandfathered.
Yes. Plans can lose their grandfathered status if they make certain changes that lower your benefits or increase your costs.
In order to keep their grandfathered status, plans can't: