Individual and Family

How Does Health Insurance Work With Marriage?

Published on March 06, 2018


When we marry, one of the benefits we often gain access to is a family health insurance plan. These plans often offer discounts because more than one person is covered. When one member of a couple has health insurance available through his or her employer, it is often the most affordable choice for gaining a health insurance plan. However, with the federal, state, and private health insurance marketplaces, there are more health insurance options available to those newlyweds who need to buy health insurance on their own.
Navigating the choices available and picking the best one for you and your spouse can take some research and some understanding of healthcare law. Let’s look at some of the basics ways that marriage changes health insurance options for you—you may be happy to find that you have plenty of choices for health insurance after marriage.

Do my spouse and I have to be on the same plan?

The answer to this is no! If you and your spouse both have individual plans that you love, there is no need to fear losing that coverage. But you also have the option to be on the same plan, which means shopping for the right one.
When couples begin shopping for individual or family health insurance plans, it can be overwhelming deciding between different options. Some couples wonder whether they must choose a family health insurance plan, or whether they can each choose their own coverage. Which option ends up being the cheaper health insurance will vary from couple to couple, so it’s good to check out all that’s available to you.
Under the current healthcare law, couples do not have to choose a family plan, nor do they have to choose the same individual health insurance plan if they choose separate policies. Which option will save the most money will depend on where you live and your family’s specific situation. A couple where both partners are in similar health, for instance, may save the most money with a family health insurance plan. If one individual has chronic health issues and the other is healthy, however, you may save more by choosing a lower deductible plan for one partner and a higher deductible, lower cost plan for the other.

Can I buy a policy on the Marketplace if my spouse has access to a company plan?

You are not obligated to buy family health insurance from your spouse’s place of work. In some cases, a family health insurance plan can be more expensive than a similar plan chosen through a private, state or federal marketplace.
However, if you have access to a family health insurance policy through your spouse’s work and choose instead to purchase through an exchange, there can be some unexpected costs. You will not, for instance, be eligible for Obamacare subsidies if you or your spouse have access to an employer sponsored health insurance plan, but still opt to buy your own plan off an exchange. When assessing relative costs between the family health insurance and individual marketplace plans, be sure to account for subsidies that you are no longer allowed. This can tell you whether the family health insurance or individual marketplace plan is the better deal for your specific situation.

What does a change in marital status do?

If you have gotten married or divorced, this is considered a Qualifying Life Event (QLE) and triggers a special enrollment period. This is because someone who was not married before would not have had access to a family health insurance plan that they are now entitled to join. By the same token, a divorce may take away your access to family health insurance. There are a few things to know about Qualifying Life Events:

  • triggers include getting married, getting divorced, having a baby or suffering a death in the family
  • you usually have up to 60 days following a QLE to enroll in a plan, such as a new family health insurance plan
  • you have a certain amount of time to add your new spouse to your existing plan, and vice versa
  • if you miss the chance to enroll, you will likely have to wait until the next open enrollment period, but in the meantime, you could opt for alternative options like short-term health insurance

Getting married is a huge step in life, and probably comes with a lot of adjustments already. Don’t think that insurance has to be complicated by this major life step—visit to see family and individual plans that come in all shapes in sizes. You can choose to purchase a completely new plan, or s
By comparing factors that include deductibles, monthly premiums, maximum out-of-pocket and other figures, you can estimate which individual or family plan best fits your needs and keeps your healthcare costs manageable.

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