<p>“You knew you were giving up grandfathered status in 2012 when you opted to switch plans. You’ve posted several times that you knew that. Your choice, your consequences.”</p>
<p>The, “You made your bed, now lie in it,” philosophy is not useful to his situation. The many distortions and incompetency involved in this law may allow the interpretation of what plans are grandfathered to be changed. Even the insurance companies appear clueless about the ACA.</p>
<p>Your own link, on page 21, doesn’t say that you lose your grandfathered status just because you CHANGED to a DIFFERENT plan. It depends. Here is what it says:
“Grandfathered status MAY be lost if changes are made to decrease plan benefits, increase the coinsurance levels or significantly change deductible or copayment levels. It can also be lost by moving to a new product family, or changing insurance carriers.”</p>
<p>I would not give up, Goldenpooch. A lot of plans might be grandfathered in the near future, even if it appears that yours will be cancelled.</p>
<p>I’ve already posted the actual LAW to GP about grandfathered plans when he debated this issue before. An inartfully worded web site or brochure doesn’t change the LAW. (By LAW I mean I pointed him to the statute). </p>
<p>GP’s very first posts to this thread were all about how he regretted his decision to give up his grandfathered plan in 2012. He made it very , very clear that he was aware of what he was doing at the time - it’s quite possible that he was given explicit notice by his insurance company of that fact.</p>
<p>As an aside, I don’t think anyone really knew what the consequences were of changing plans in early 2012 because of a premium increase. Who knew about these very narrow networks and how costly these plans were going to be for unsubsidized subscribers.</p>
<p>Just saw your post Calmom. I checked my correspondence with the insurance company and I received nothing in writing which said anything about losing my grandfathering status.</p>
<p>To be honest it’s hard to remember what I thought. I knew it was possible before getting my cancellation notice last month, but I am really not sure what I was thinking in early 2012. I do know I have nothing in writing from them. I checked all my correspondence with them and they never sent me anything notifying me or even warning me I would lose my grandfather status. So who knows?</p>
<p>As you can tell from my forum name, I have a golden retriever. I can honestly say he has better insurance than me. The policy has a $250 deductible and then he has 90% coverage of all medical bills for any vet in the US. I would like to trade policies with him.</p>
<p>Judging from the formatting, it looks like the type of paper that would be slipped in among a packet of documents, perhaps the same renewal packet that contains notice of the rate increase. I could see the possibility of it being slipped into the folder or brochure they send and being missed. (The type style and the blue headings is the typography they use in those types of mailings, which I am sure you are familiar with)</p>
<p>What company insures your dog? I have my dogs insured with PetPlan with a $200 per incident deductible, but there’s a $22,000 upper limit. I wouldn’t bother paying for a policy with such low limits for myself - it wouldn’t go very far.</p>
<p>Yeah, I have PetPlan, too. Okay, I exaggerated, forgot about the $22,000 limit. I guess that wouldn’t work for me.</p>
<p>Calmom, I know said that but now I think I was confused by what I knew in the last couple of months and what I may have known then. I really can’t remember what I knew then. I know I was not focusing on if the plan was grandfathered. I was really thinking about the premium increase and trying to determine if the plan I was transferring to was a good option for me. I kept all the correspondence and there is nothing there advising me or notifying me about this grandfather issue.</p>
And that’s the doggie Gold plan. The Bronze plan for dogs only goes up to $10K. </p>
<p>I’m thinking that what probably happened in 2012 is that you got a notice of a premium increase you didn’t want to pay, and probably called up Blue Shield and asked to talk to an agent about whether there was a more affordable plan. And the agent probably told you over the phone that they did have other plans, but that you would lose your grandfathered status if you switched. And based on what you’ve said, I agree that you probably didn’t fully realize what it meant, and were more focused on your goal of saving money on a monthly premium. </p>
<p>I still don’t really understand why you think you would be better off on the old plan. I’m pretty sure that the 2014 premiums on that plan are going to be higher than the premiums for Bronze level plans on the exchange. I know that you are worried about the networks, but there is absolutely nothing to prevent Blue Shield from dropping particular doctors or providers from their network at any time. So you very well could have been paying higher premiums for the past two years, and facing even higher premiums in January in order to keep the plan – only to get a letter in the mail in a few months announcing that UCLA and Cedars were being dropped from the network and notifying you that you needed to choose different health care providers at a specified future date. </p>
<p>I mean, you seem to have all the paperwork on hand – read your policy. I don’t think there’s anything in there that promises to keep any particular doctor or facility on the network. I don’t think you really want to be in the 2014 grandfathered version of the Shield Savings 3500 plan. I think you want the plan you had in 2012, and that’s gone. The 2014 grandfathered plans are going to have rapidly escalating rates as their coverage pool ages and shrinks – and people are going to want to leave those plans fairly quickly when they start comparing rates.</p>
<p>You may be right but I was told by Blue Shield a few weeks ago that they have not notified anyone about premium increases for their grandfathered plans. They would have to increase it by a lot to be higher than what I would have to pay for the bronze plan. At this point, I would prefer the $5,200 plan, which also predated the March 2010 deadline. </p>
<p>I would feel better if any of the doctors I am comfortable with were in the network for the bronze plan. The network for the grandfathered plans practically covers every hospital in Ca and all the doctors we like in my town. You’re right, they could drop providers or greatly increase rates, but as of now they haven’t done that.</p>
<p>If I have to transfer to the bronze plan, I am leaning to going with Anthem because of the UC hospitals, but not really sure because who knows what is in their network. </p>
<p>To be honest I am not too concerned about the doctors, but am definitely more troubled by the very narrow network of hospitals. I know we disagree about this, but I have two very good friends, one who needed care at UCLA and the other at Cedar Sinai. Our community hospital was not a good option for either of them. Considering how expensive hospitalization is nowadays, it would practically be impossible to go to any hospital out-of-network, unless you’re very rich. This is what I really want insurance for, to protect me from the six or seven figure medical bill for a catastrophic condition which needs very specialized care. Now I am hoping nothing like this ever happens, just like I don’t want my house to burn down; but regardless of what I may wish for, I am going to have insurance to protect me from that worst case scenario. It is why I have an umbrella liability policy, earthquake insurance and long term care insurance. Although no one wants to think about these things, I sleep better at night knowing I have all my bases covered.</p>
<p>BTW, if you think underwriting is a problem for health insurance in the past, you should have seen what we had to go through to get long term care insurance in 2010. They required all medical records from every doctor we had seen in the last five years, and had a visiting nurse come to our house to give us memory and blood pressure tests. The memory test kind of freaked me out, but I guess I passed. </p>
<p>At one point they were going to deny us because my wife was prescribed valium (I think?) during a week when we had a major fire in my town and for a while it didn’t look good for my house. She happened to have a physical scheduled during that week, and she had been hyperventilating a little because of all that was going on (we had to evacuate), so the doctor gave her some medication for it. The LTC insurance company totally overreacted and was going to turn us down for who knows why. Fortunately, they calmed down and it turned out okay. That was intense underwriting.</p>
<p>“I’ve already posted the actual LAW to GP about grandfathered plans when he debated this issue before. An inartfully worded web site or brochure doesn’t change the LAW.”</p>
<p>Well, you are the one who pointed to page 21 of the inartfully worded brochure to GP, as evidence of why he will lose his grandfathered status.</p>
<p>Seeing as very few actually even understand how to implement the law, GP may have nothing to worry about. If he hasn’t gotten a cancellation notice yet, perhaps the insurance company is still considering him grandfathered, whether they are technically right or wrong. It is likely they have no clue of what they’re doing.</p>
<p>GP, just one person’s opinion, but I figure, if you might not like the answer, don’t ask the question. Do you really want to flag your policy for them to take another look? I’d just keep a close eye on my mail in case they send you a cancellation notice, and be ready with a backup plan just in case.</p>
<p>I can tell you for my company, everything is in print for us to look at. But when it comes to implementing policy, there is the teensy tiny fine print that only the bean counters have access to, to use as they choose. Maybe nobody knows yet about your policy. Say a prayer when you’re getting your mail!</p>
<p>Cardinal Fang: If a person hasn’t paid his premium, are doctors going to be able to collect for the treatment provided? There’s a lot to this whole scheme that doctors and exchange enrollees don’t know yet. I found this information in one article. Never saw it mentioned before anywhere. </p>
<p>It’s another disincentive for doctors to contract with the exchange plans.</p>
<p>“I think GP needs to watch out for the “Where to relocate to minimize your premiums” thread. He may have better luck there.”</p>
<p>You may be saying that in jest…but I think that will be a future reality. Right along with where to relocate to minimize your taxes, minimizing premiums is going to be a big player. This could be one of the largest expenses in someone’s life. It’s already larger than mortgage payments, college expenses, or taxes for some.</p>