What does it mean to be "grandfathered" in a health insurance plan?

Being "grandfathered" in a health insurance plan means that the plan was in existence before the Affordable Care Act (ACA) was enacted and can retain certain original features as long as it does not make significant changes. This provision allows individuals who had certain health insurance plans prior to the ACA to keep those plans, even if they do not meet all of the ACA's new requirements.

This status is important because it enables some plans to avoid certain regulations, like those concerning essential health benefits or preventive services, as long as they stay unchanged significantly. Consequently, individuals with grandfathered plans might face different benefit structures or cost-sharing arrangements compared to new plans developed under the ACA framework. This distinction is crucial as it shapes the type of coverage individuals may have, highlighting the importance of understanding the implications of plan status in relation to evolving healthcare regulations.