One of the major selling points of the Affordable Care Act was the idea that if an employer or individual was happy with their current health plan or coverage, they could keep it. Not necessarily. Under the ACA, employer plans and insurance coverage that was in place on March 23, 2010 was excused from many of the health care reform mandates, so-called grandfathering. However, upon closer inspection, there are many circumstances under the ACA where an employer or individual cannot simply keep their current health plan and changes must be made to the plan or policy to comply with a broad range of mandates under the ACA. Keeping your current health plan intact is, in reality, no easy task.
In the individual market, many current policies that are not grandfathered do not cover the package of essential health benefits mandated by the ACA which includes: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
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