Grandfathered plans are health plans that were in existence on March 23, 2010, and haven’t been changed in ways that substantially cut benefits or increase costs for plan holders. These plans were not sold through the Marketplace. They were sold directly by insurers or insurance agents or brokers.

If you have a grandfathered plan, you may not get some rights and protections that other plans offer under the Affordable Care Act. Your insurer must notify you if you have a grandfathered plan.

FYI: If your insurance company cancels your grandfathered plan

Switching to a Marketplace plan

If you have one of these plans you can switch to a Marketplace plan that covers pre-existing conditions.

Types of grandfathered plans

Job-based grandfathered plans

Job-based grandfathered plans can enroll people after March 23, 2010, and still maintain their grandfathered status if the plans:

  • Haven’t been changed in ways that substantially cut benefits or increase costs for plan holders

  • Notify plan holders that they have a grandfathered plan

  • Have continuously covered at least one person since March 23, 2010.

Individual grandfathered plans

Individual grandfathered plans can’t newly enroll people after March 23, 2010, and have that new enrollment be considered a grandfathered policy. But insurance companies can continue to offer the grandfathered plans to people who were enrolled before that date.

An insurance company can also decide to stop offering a grandfathered plan. If it does, it must provide notice 90 days before the plan ends and offer enrollees other available coverage options. Learn more about plan cancellation.

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

Protections that apply to all health plans

All health plans, including grandfathered plans, must:

Protections that DON’T apply to grandfathered plans

Grandfathered plans DON'T have to:

Protections that DON’T apply to individual grandfathered plans

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.

More answers

If I have a grandfathered plan am I considered covered?

Yes. Grandfathered plans count as qualifying health coverage. This means you're considered covered under the health care law.

What if my grandfathered plan changes significantly?

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
Can a plan lose its grandfathered status?

Yes. Plans can lose their grandfathered status if they

  • Significantly cut or lower coverage
  • Raise coinsurance
  • Significantly raise copayments
  • Significantly raise deductibles
  • Significantly lower employer contributions
  • Add or tighten a yearly limit on what the health plan pays