What can patients expect under a grandfathered plan?

Under a grandfathered plan, patients can expect continuity in benefits that were established before the Affordable Care Act (ACA) was enacted. These plans are those that were in place on March 23, 2010, when the ACA was signed into law. As long as the plan maintains its grandfathered status by not making substantial changes to its coverage, it can continue to offer benefits that were in existence prior to the ACA.

Grandfathered plans do not have to comply with many of the ACA's new requirements, such as coverage for preventive services without cost-sharing and the prohibition on lifetime limits for essential health benefits. This allows these plans to potentially keep their traditional benefits, which may differ from what newer plans are required to offer under the ACA.

The other options do not accurately reflect the nature of grandfathered plans. For instance, grandfathered plans may not necessarily have lower premiums and deductibles compared to non-grandfathered plans, and they are not mandated to include significant changes in coverage benefits just because they are grandfathered. Participation in wellness programs is a separate issue and is not a requirement for grandfathered plans. Thus, the expectation of continuity in benefits aligns precisely with the nature of grandfathered plans.