Saturday, September 4, 2010

Health Reform Surprise

I got a disturbing letter from my insurance company late yesterday in the mail. Here's a portion of the letter:

"Because you enrolled in your plan on or before March 23, 2010, your health plan is considered 'grandfathered'. This has certain advantages. For example, your plan does not have to adopt some of the requirements of health care reform. Your plan's 'grandfathered' status allows you to keep your current health plan.

If you want all of the health care reform benefits, you can move to a different health plan after September 23, 2010. However, if you change plans:

- a personal health history may be required

- the new plan may have a higher premium (due to health care reform benefits)

- you will no longer be in a 'grandfathered' plan"

What the hell?!? I had no idea some of the health care reform benefits didn't apply to existing plans. Obviously I can't change plans. I can't imagine they would even give me insurance knowing what they know about me now. If they did I certainly wouldn't be able to afford it. I can barely afford the yearly increases now.

The language in this letter is irritating. Talking about the advantage of the "grandfathered" policy being that I don't have adopt some of the health care reform benefits. Seriously? They call that an advantage - for me? I see how it could be an advantage for them, but I fail to see how that could possibly benefit me.

The thing is, I don't even want to change plans. Considering my current health situation I'm in an ideal plan (in relationship to other plans out there). It is pretty expensive but there is a yearly cap that I always reach in the first quarter of the year and then I'm covered at 100% after that. Additionally, there is tremendous flexibility in where I can go and who I can see. I wish it included mental health care and infertility treatments but overall I'm glad to have the coverage I have.


Now I'm just left wondering - what benefits will I not be eligible for? Is this even true? Can they really deny me rights because I've had my insurance plan for several years?

I'll have to add a call to Blue Cross to my To Do list for Tuesday and see what I can find out about what benefits I'll be missing out on.


  1. Sounds like some VP is trying to put a positive spin that you won't be eligible for something like the extended mental health coverage changes or having adult children on your plan past the age your current coverage allows. Only insurance companies would call that a "plus" - and the preexisting condition clause is one of the last parts of the law to move forward. Good Ol' BCBS makin money while they can!

  2. I'm not even sure it works that way. I will try to do some research and I encourage you to do the same. Assholes.

  3. Here is one link that provides some information:

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  5. I don't think grandfathered policies can stay grandfathered for very long. it doesn't take much to trigger them into changing. Check this out:

  6. Thanks for the good information! Trying to understand this stuff is a bit overwhelming I really appreciate your directions.

  7. oh my! I wonder if I will have the same problem. I like you, will not be insurable again either. This is just not fair. i haven't heard from my insurance company yet so i don't know what changes will effect me.

  8. I also have a life threatening medical condition. I am interested in how the health care reform bill is going to affect me and the medications I take. I know what you mean about easily meeting the deductible and or out of pocket pay before the year is half way thru. The grandfathered plan is actually a very very good thing. Basically they are saying you will be covered normally how you would if the health care reform had not happened without an increase in payments. However with the health care reform when the year is up and you go to renew your insurance or you get a new insurance carrier you can either be denied coverage and or be charged out the ass for coverage. That is what scares me the most is I will not be eligible for coverage once this health care reform bill comes into complete play. The health care reform bill is going to end up killing a lot of the chronically ill and elderly patients. IT IS SCARY