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Health · Chapter 15 · Statutes

Grandfathered Plan

Definition
A plan unchanged since March 23, 2010 (pre-ACA). Exempt from covering free preventive care, essential health benefits, and individual-market pre-existing conditions — but it can't significantly increase cost-sharing (any coinsurance hike, or copay/deductible hikes beyond medical inflation + 15 points) without losing status, and can never impose lifetime dollar limits.
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These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.

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Verified against primary sources · 2026-08-05