Marriage is the union of two people becoming one. Their personal, legal, and medical lives are intrinsically woven together, and sometimes that leads to questions you wouldn’t usually think about, such as married health insurance.
Do I need to think about changing my health insurance after marriage? Will I lose my health insurance if I get married?
These are questions that may arise when you discuss married health insurance.
What Is Mine Is Yours
When two people are married, many things become shared, including health insurance. In fact, married health insurance is often the best option if only one spouse is employed and both individuals are in relatively good health. Many employers offer spousal health coverage at a discounted premium compared to individual health insurance plans.
However, not all employers offer health insurance, and even fewer allow spouses on existing health insurance, which includes married health insurance plans. Plus, if you or your spouse have chronic health conditions requiring more comprehensive care, you may need more coverage than the other, making a shared plan ineffective.
When looking for married health insurance, you want to weigh the pros and cons of being on your spouse’s plan or seeking out individual coverage.
Spouse-Dependent
Spouse-dependent insurance is reliant on your spouse. If the union is broken, the insurance stays with whoever is the policy owner. When you enter your spouse’s insurance plan, there are a few things to consider.
Pros
- Less expensive
- Spouse-dependent plans are less expensive than individual plans.
- Less paperwork
- Since the plan has both individuals on it, there is less paperwork.
- Same doctors
- Sharing a plan means sharing which doctors are in your network.
- Using doctors outside of a health plan network can be more expensive.
- Easier coverage management
- Similarly to less paperwork, any changes to your policy affect both you and your spouse.
- There is no need to micro-manage every subscription or policy when you share one.
Cons
- Not always offered by employers
- Only some employers offer spouse-dependent health coverage.
- Health insurance may not even be offered by the employer, especially for married health insurance.
- Relies on job/spouse security
- If your spouse loses their job, you lose health coverage with them.
- May be more expensive
- Some employers charge a spousal surcharge to create married health insurance.
- Can be less effective for chronic health conditions
- If you suffer from chronic health conditions, relying on your spouse’s insurance may not be possible.
Individual
Individual insurance plans are specific to the policy owner. The premiums can often be higher than a spouse-dependent policy, but it depends on your needs compared to what your spouse’s insurance can offer. Plus, if the marriage ends, your policy will not be affected.
Pros
- Personalized coverage
- Individual policies are tailored to your needs.
- You can pick and choose what services and coverage you need.
- Not spouse-dependent
- Newly-married health insurance can be lost if spouses split up.
- Individual policies stay with the owner and no one else.
- Varied providers
- Individual plans can come from any provider.
- Married health insurance usually forces one provider.
Cons
- Higher premiums
- Individual coverage is often more expensive than newly married health insurance.
- Certain income-dependent groups cannot easily afford it.
- Excessive paperwork
- With two individual policies, there is more paperwork.
- Easy to lose policy notifications and updates in mismatched paperwork.
- Different doctors
- Some individual plans are not accepted by certain physicians, leading to spouses visiting different doctors.
Where Can You Find More Options?
If you are thinking, “will I lose my health insurance if I get married?” The answer is no. Health insurance, especially individual policies, is unique to the policy owner. Changing health insurance after marriage isn’t necessary if you are happy with your current policy.
In fact, marriage can even open you up to getting affordable health insurance coverage through the Affordable Care Act (ACA), as marriage is considered a qualifying life event.
Qualifying Life Event
A qualifying life event (QLE) is an event that triggers a special enrollment period for ACA-compliant policies through your employer or marketplace. These are some of the events that are considered a QLE.
- Marriage
- When you get married, it is considered a qualifying life event.
- Marriage is a significant and weighty decision.
- Divorce
- When you divorce your spouse while sharing a plan with them, you could lose your coverage.
- This makes divorce a qualifying life event, as the ACA can help you find affordable plans to supplant the loss of your spouse’s insurance.
- Having children
- When you have children, health insurance becomes more important than anything.
- Since children cannot protect themselves, their birth is considered a qualifying life event.
- It opens up a special enrollment period to receive an ACA-compliant policy through your employer or a private marketplace.
With a QLE, individuals can enroll in ACA-compliant policies regardless of open enrollment status. This makes it an excellent time to find a new policy, add your spouse to your policy, or join your spouse’s policy.
But how do you know what kind of insurance you need? How do you navigate the marketplace or find an affordable policy through the Affordable Care Act QLEs? Should you enroll in married health insurance and share a plan with your partner? Or is it beneficial to seek out individual plans so chronic health issues can be addressed?
Your Plan Insurance can help. Our licensed agents can help you navigate QLEs and the ACA. We can help you find married health insurance or individual policies through the ACA, giving you the knowledge to make an informed decision that benefits your health and your spouse’s health.
If you have questions about ACA-compliant policies, married health insurance, or spousal coverage, or if you are thinking about changing your health insurance after marriage, be sure to get in touch with us immediately, and one of our licensed agents will answer any questions.