QUESTION

I’ve had the same insurance policy since 2013 because the premiums are lower than the new plans that must comply with the Affordable Care Act. My insurer is offering me the option to renew my current policy again. What are the pros and cons of doing that?

Individuals with coverage | Individual and Marketplace Health Coverage
ANSWER

In most states you have the option to renew that policy (often referred to as "transitional" or "grandmothered" policy). Grandmothered policies, which existed prior to the implementation of the Affordable Care Act’s insurance reforms, do not have to meet certain provisions of the Affordable Care Act including the essential health benefits standard and the prohibition on health status discrimination See Resources, ACA Consumer Protections for Private Coverage.

In addition to being exempt from some consumer protections under the Affordable Care Act, you may be ineligible for the premium tax credits and cost-sharing reductions because those are only available through the health insurance marketplace. Before you renew your policy, you should check your eligibility for premium tax credits via the health insurance marketplace and compare your health plan options. Even without financial assistance, you may find a more affordable option that provides the full range of consumer protections granted under the Affordable Care Act. Individuals should take the time to compare all of their options before making a decision.

NOTE: Some states have prohibited insurers from renewing policies that were renewed in 2013. If you’re not sure whether your insurer is complying with state law, check with your state’s Department of Insurance. States can allow these types of health plans to continue to be renewed until October 1, 2019; however, transitional policies cannot extend past December 31, 2019. (CMS, Insurance Standards Bulletin Series - Extension of Transitional Policy Through 2019, April 9, 2018).

Related Tags

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues