What to know about health insurance after getting married
Marriage brings together many things, like hearts, households, finances — and even health insurance. True, it may not be the most romantic notion, but marriage is one of the qualifying life events that allows you to change your insurance plan or add your spouse to your plan outside of the open enrollment period.
And most health insurance plans require you to make those changes to your health insurance within 60 days of walking down the aisle.1
While you may feel overwhelmed by all the pre-wedding decision-making, choosing the best health insurance plan for you and your new spouse is an important step in combining your lives. Here are 6 tips that will help you navigate the health insurance changes that come along with marriage.
Tip #1: Find out if both of you can be covered under an employer policy
You may assume that your spouse can automatically join your health insurance because you’re getting married. But that isn’t always the case, says Cindi Gatton, vice president of Healthcare Advisory at Caribou, a company that offers software to financial advisers for planning and optimizing health care costs.
“Not all employers permit spouses who have access to their own employer coverage to be covered under their employee’s plan,” says Gatton. “Knowing whether one or both of your employers allows this can simplify your decision.”
Tip #2: Consider the amount that you and your spouse travel
While it may not be top of mind when choosing health insurance, travel plans could impact your care.
“If you are planning on staying put for the foreseeable future, opting for a health maintenance organization, or HMO, network plan may get you lower premiums,” says Noor Ali, M.D., a health insurance adviser at Dr. Noor Healthcare Advisor. HMOs can offer lower premiums because they have smaller networks of care, close to home.
However, if you and your new spouse enjoy traveling, she says, “preferred provider organization, or PPO, plans have wider nationwide networks that are more suitable for digital nomad lifestyles and other frequent travelers.”
Tip #3: Compare the premiums for coverage together vs. separate insurance plans
It might not always make sense financially for both of you to be covered under one employer plan.
“Many employers heavily subsidize the premiums for their employees, but not as much for spouses,” explains Gatton. “So knowing the cost of single coverage versus the cost of employee-plus-spouse coverage is important to consider.”
Tip #4: Check to see if your providers are in the health plan’s network
If you want to keep seeing your current doctor, but they don’t accept your spouse’s insurance, that could be a roadblock.
“If each employer uses a different insurance carrier, the provider networks will be different,” says Gatton. “Checking the provider directory to see which plan has the best match for the providers you use can also help with decision-making.”
Tip #5: Budget using the monthly insurance premium
You’ll be paying for health insurance each month. That premium can add up to more than the care you and your spouse may need. That’s why the monthly premium is a good place to start when it comes to budgeting.
“Understanding which plan has the lowest deductible is a factor many couples also consider when deciding which plan best suits them,” says Gatton. “You pay the monthly premium whether you use health care or not. Understanding that financial commitment is helpful from a budgeting standpoint.”
Tip #6: Think about whether you and your spouse have the same medical needs
It’s important to compare your own health needs with your spouse’s when it comes to health insurance.
Know the deductibles for the plans you’re considering. The deductible is the amount you pay for health care before there is any cost sharing with the insurance company.
“It’s a good idea to have the deductible amount saved in your rainy-day fund, if you can, since that will be your financial obligation. And don’t forget to compare the out-of-pocket maximums as well,” says Gatton. That’s the most you’d have to pay in a plan year.
Dr. Ali adds: “Are you both generally healthy? Both chronically ill? Or maybe you’re on opposite spectrums? Starting the health insurance research journey with a needs assessment can be the key to saving hundreds or thousands of dollars on premiums each year.”
Combining health insurance plans and being on the same policy is generally a cost-saving strategy, but it may have the opposite effect when one spouse has higher medical expenses than the other.
As with many things in your new marriage, health insurance is something that’s best figured out together, so you and your spouse can make a choice that’s right for your future.
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