I have *zero* idea where to put this thread and am not sure where else I can ask this. Â Disclaimer: Â I don't care what anyone things about the plan, whether it's good, or bad. Â I don't want debate on the merits of the reform or desired repeal.
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What I really want to know is about the whole "grandfathered plan" business. Â Dh has h/i through his employer. Â We've been on the plan since he started about 2 1/2 years or so ago. Â I don't think it's been changed since they upped our out of pocket maximum, but that was well before the passage of the PPACA. Â They just signed a new contract, but I don't believe there were any changes to the health plan. Â I'm assuming this means it's a "grandfathered plan," right?
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The only reason why I care is because our h/i does not cover well-child/preventive care for children older than 4. Â It covers preventive visits for my husband and myself as well as our two youngest children, but not my son. Â I'd, obviously, really like to have him covered as well. Â So...I'm figuring our h/i plan is exempt from the preventive care w/out cost sharing requirements part. Â Does anyone know if there's a point in time at which even grandfathered plans will have to cover this?
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TIA - I've been trying to figure this out. Â Yes, I know I can call the third-party admin for the plan (which is self-funded), but they're snotty and not the slightest bit helpful. Â I'd like to better understand the issue before I give them a call.






