March 23,2010 – Why is this Date Significant to Those Who Have an Individual Health Insurance Plan?

 It is the date that President Obama stated that if you like your current health insurance, you can keep it.  It is the date that your individual health plan can be “grandfathered”, according to the new Affordable Care Act.  If you purchased your plan before this date (and it hasn’t been through certain changes since then), you can keep it.  Or you can change it if you can find something better or less expensive.  It is up to you to decide whether to keep your grandfathered plan.  The following are reasons to help you decide.

Three Reasons to stay grandfathered:

  • Your current plan will not have to include some of the benefits that the Affordable Care Act (ACA) now requires of the new plan.  For example, you will not be paying for maternity coverage if you do not need it.  This could help control costs over time, but it does not guarantee that rates will be lower now or in the future.
  • Your current plan will not be limited to certain “categories, also known as the metal plans” that will take place in 2014.  For example, if you currently have a plan with rich benefits, you may not be able to buy one that is as good.
  • Many health care reform provisions will not apply, so you would not be affected by the changes that could change your deductible or share of cost.

Four Reasons NOT to stay grandfathered:

  • A new plan would include all of the additional benefits the new law requires, including expanded preventative care.
  • You would have more flexibility to manage your premiums by choosing different benefits or increasing your deductible.
  • By staying in the old plan, you would be part of a “closed” plan that is no longer sold to new applicants.  That means you could see higher premiums or costs which typically happens when new and healthy applicants are not being added to the “closed pool” of members.
  • In order to receive a subsidy (based on income and family size) for your premium, a new plan has to be purchased through the Marketplace Exchange.

If your individual health plan was effective after March 23, 2010, you may stay in your current plan until its policy anniversary date unless you choose “metal plan” before that time.