don’t, here is what it means. https://www.healthcare.gov/glossary/grandfathered-health-plan/ On March 23, 2010, then president Obama, signed into law the Affordable Care Act. Any plans purchased before that date are called “grandfathered” plans. If you’ve kept this plan for this long it’s probably because of the large network of doctors and hospitals. In the past it was common to have a health insurance plan where you can see almost any doctor or hospital in the country. Nowadays it’s almost impossible. Most insurance plans are managed care plans which are commonly known as HMO plans. They limit you to one primary care physician (PCP) and that PCP has to write you referrals to see other doctors. This is why, if you’re on a grandfathered plan, you’re holding on to it because you want to see the doctors you’ve been seeing your whole life when you want whenever you want. Unfortunately, the insurance carriers are making it really difficult to keep your plan because they keep raising your rates significantly.
Paying way too much…
I had a client today call me and told me that she is currently paying $1400 a month. In July she gets a rate increase to $2200 a month! In most cases that’s more than a mortgage payment. So she asked me If I could help her. These are the ways you get another plan…
- You have to have a special enrollment period (SEP) https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/.
- Apply during Open Enrollment (OE) https://www.healthcare.gov/glossary/open-enrollment-period/
- Grandfathered plan loses its grandfathered “status”
What does it mean to lose its grandfathered status? Well, it cannot…
- Significantly cut or lower coverage
- Raise coinsurance charges
- Significantly raise copayment charges
- Significantly raise deductibles
- Your employer cannot significantly lower its employer contributions
- Add or tighten a yearly limit on what the health plan pays
These are the ways you can get out of a grandfathered plan that might be breaking the bank.
What to do next…
Contact us, or click on this link https://www.healthsherpa.com/?_agent_id=carlos-pulido-yveeca and fill out the application. Once you’ve filled out the application you will notice that it will say you DO NOT have a SEP. Don’t worry this is normal. The secret is after you are done with the application we’ll call the marketplace and we’ll have to speaking with a tier 2 level representative. Tier 2 level representatives have the power to manually create a SEP for you. Viola! At this point we can change to a different plan.
If the plans offered through the marketplace are too expensive, we’ll look at alternative options like short term medical and fixed-benefit plans. Don’t do it all alone. Contact us today. Don’t pay too much for your grandfathered plan. Change now.
Wishing you good health,
