Marriage: A Gateway To Insurance Changes

Marriage is a significant life event that can impact your finances, including your insurance plans. Indeed, getting married is considered a qualifying life event that allows you to change your insurance plan or add your spouse to your existing plan outside of the standard open enrollment period. This opportunity is typically available for a limited time, usually within 60 days of your wedding day.

Combining health insurance plans with your spouse can often lead to cost savings. However, it is essential to carefully consider various factors when making these decisions, such as travel plans, provider networks, premiums, deductibles, and each spouse's medical needs.

Marriage is a qualifying life event for health insurance

Marriage is a significant life event that has implications for various aspects of a person's life, including their insurance. In the context of health insurance, marriage is what is known as a "qualifying life event," which allows individuals to make changes to their insurance plans outside of the standard open enrollment period. This means that if you get married, you will be able to add your spouse to your existing plan or purchase a new plan that suits your new situation.

Special Enrollment Period

The addition of a spouse to one's life is considered a significant change in circumstances, which is recognised by health insurance providers. This recognition takes the form of what is known as a "special enrollment period." This period typically lasts for 60 days following the marriage and allows individuals to make changes to their health insurance plans or add their spouse to their existing plan. It is important to note that this window of opportunity is limited, and if individuals miss the 60-day deadline, they will have to wait until the next open enrollment period to make any changes to their health insurance coverage.

Comparing Plans

When it comes to choosing the best health insurance plan for a newly married couple, there are several factors to consider. Firstly, it is important to find out if both spouses can be covered under a single employer policy. While it may seem natural to assume that a spouse can automatically join their partner's health insurance, this is not always the case, and employer policies vary on this matter. Secondly, the amount of travel that the couple intends to do should be considered. If the couple plans to stay in one place, a health maintenance organisation (HMO) network plan may offer lower premiums. On the other hand, if the couple enjoys travelling, a preferred provider organisation (PPO) plan may be more suitable, as it offers a wider nationwide network.

Financial Considerations

Another important consideration is the financial impact of combining health insurance plans. In some cases, it may not make financial sense for both spouses to be covered under a single employer plan. It is common for employers to heavily subsidise premiums for their employees but offer less generous subsidies for spouses. Therefore, it is essential to compare the costs of single coverage versus employee-plus-spouse coverage. Additionally, it is worth checking if the providers the couple wishes to continue seeing are included in the health plan's network.

Deadlines and Documentation

Most health insurance plans require changes to be made within 60 days of the marriage taking place. This deadline is important, as missing it will result in a wait of several months until the next open enrollment period. Furthermore, it is important to note that proof of marriage, such as a marriage certificate, is typically required when making changes to a health insurance plan due to a qualifying life event.

You can add your spouse to your plan

Marriage is a "qualifying life event" that allows you to change your insurance plan or add your spouse to your plan outside of the open enrollment period. You will have a window of time after your wedding date to make these changes, with most health insurance plans requiring you to make changes within 30 or 60 days of getting married. If you miss this deadline, you will have to wait until the next open enrollment period to make any changes.

If you have employer-sponsored health insurance, you will need to check with your company's benefits department to know the dates, as they have their own open enrollment period. You will also need to show proof to take advantage of a special enrollment period, such as submitting a marriage certificate.

If you have a Marketplace plan, you can add your spouse during open enrollment or during a special enrollment period after getting married. You will need to log into your Marketplace online account and select "Report a life change" to update your application and insurance coverage.

Before adding your spouse to your health insurance plan, it is important to compare both of your health insurance options by considering total costs, benefits, and specific factors such as out-of-pocket expenses, levels of coverage, and dependent coverage. This will help you determine whether it is more cost-effective to be on the same plan or maintain separate plans.

You can change your insurance plan

Marriage is a significant life event that brings together many things, including insurance plans. If you have insurance coverage through an employer, getting married is a "qualifying life event" that allows you to make changes to your insurance plan or add your spouse to your existing plan. This is possible even outside of the open enrollment period, but it must usually be done within 60 days of your wedding.

Find out your options

Determine if both you and your spouse can be covered under an employer policy. Not all employers allow spouses to join their employee's plan, especially if the spouse has access to their own employer coverage. Understanding the options available to you will simplify your decision-making process.

Compare travel plans

If you and your spouse plan to stay in the same area for the foreseeable future, opting for a Health Maintenance Organization (HMO) network plan may offer lower premiums. HMOs often have smaller, local care networks, making them a more affordable option for those who don't require a wide range of travel options.

On the other hand, if you and your spouse enjoy travelling, a Preferred Provider Organization (PPO) plan may be more suitable. PPOs have wider nationwide networks that can accommodate digital nomad lifestyles and frequent travellers.

Evaluate financial considerations

Compare the premiums for coverage together versus separate insurance plans. Employers may heavily subsidize premiums for their employees but offer lesser subsidies for spouses. Understanding the cost of single coverage versus employee-plus-spouse coverage will help you make an informed decision.

Additionally, consider your monthly insurance premium and budget accordingly. You will need to pay this amount regardless of whether you use the health care services or not, so it is a crucial factor in your financial planning.

Assess your medical needs

Compare your health needs with your spouse's to determine the most suitable insurance plan. Consider the deductibles and out-of-pocket maximums offered by different plans. The deductible is the amount you pay for healthcare before cost-sharing with the insurance company begins. Having this amount saved in your rainy-day fund is advisable, as it will be your financial obligation until the insurance company starts contributing.

If you and your spouse have similar medical needs, finding a plan that caters to those specific needs can save you money. However, if one spouse has significantly higher medical expenses than the other, being on separate insurance plans may be more cost-effective.

Review your providers

If you wish to continue seeing your current doctor, ensure that they accept your spouse's insurance. Different employers may use different insurance carriers, resulting in varying provider networks. Checking the provider directory will help you choose a plan that includes the healthcare providers you prefer.

Make timely decisions

Remember that you typically have a limited time frame, often 60 days, to make changes to your insurance plan or add your spouse after getting married. Once this special enrollment period ends, you will likely have to wait until the next open enrollment period to make any changes to your coverage.

Marriage also changes how you qualify for health insurance subsidies under the Affordable Care Act. Your combined income as a couple will determine your eligibility for financial assistance. Take this into account when reviewing your insurance options.

You have 60 days to make changes

Marriage is a significant life event that allows you to make changes to your insurance policies. Most health insurance plans require you to make changes to your insurance within 60 days of your wedding. This is known as a special enrollment period. Here are some important things to keep in mind:

• Deadlines: It is crucial to be mindful of the deadlines associated with your special enrollment period. If you miss the 60-day window, you will have to wait until the next open enrollment period to make changes to your insurance plan. The open enrollment period typically occurs annually and is when anyone can make changes to their health insurance.
• Documentation: You will need to provide documentation to prove your marital status. A copy of your marriage certificate is usually required to add your spouse to your insurance plan.
• Comparing Plans: If both you and your spouse have insurance coverage through your employers, compare the benefits and costs of each plan. Consider factors such as monthly premiums, deductibles, out-of-pocket maximums, and whether your current healthcare providers are included in the plan's network.
• Spousal Surcharge: Check if your employer plan has a "spousal surcharge," which is an additional fee added to your premium if you choose to cover your spouse when they are eligible for coverage through their employer.
• Family Plans: If you decide to be on the same health insurance plan, you will be considered a "family," even if you don't have children. Family deductibles tend to be about twice as much as those for individuals. Some plans have "embedded" deductibles, meaning once any family member reaches the individual deductible, the insurance company starts covering their costs. Other plans have "aggregate" deductibles, where the family deductible must be met before any member receives full coverage.
• Health Needs: Consider your and your spouse's health needs. If one partner is generally healthy, they might opt for a lower-cost plan with a higher deductible. On the other hand, if one partner has higher medical expenses, they might select a higher-cost plan with a lower or zero deductible.
• Government Marketplace: If you use the government Healthcare Marketplace, remember that your household income will increase after getting married, which may impact the tax credit available to help pay for health insurance.
• Other Insurance Policies: Marriage can also bring changes to other insurance policies, such as auto insurance and homeowners' insurance. Contact your insurance providers to understand how your rates may be impacted and to inquire about any discounts for married couples.

You can shop for a new plan

Marriage is a "qualifying life event" that allows you to shop for a new insurance plan or change your existing plan outside of the open enrollment period. This is applicable to both individual health insurance plans and employer-sponsored plans. Here are some important things to keep in mind when shopping for a new plan after getting married:

Know Your Options

Before making any decisions, it's essential to understand your options. You can explore different insurance providers and plans available in your area. Compare the benefits, coverage, and costs associated with each plan to make an informed choice.

Special Enrollment Period

As a newly married couple, you are typically allotted a special enrollment period of 60 days to shop for a new insurance plan or make changes to your existing plan. This period usually starts from your wedding day, so be sure to mark your calendars and not miss this window of opportunity.

Employer-Sponsored Plans

If either or both of you have access to employer-sponsored health insurance, find out the details of these plans. Understand the coverage, premiums, deductibles, and any restrictions involved. Some employers may not allow spouses to join their employee's plan if they have access to their own employer coverage, so clarify this beforehand.

Travel Considerations

If you and your spouse frequently travel or plan to stay in one place, consider how this might impact your insurance choice. Health Maintenance Organization (HMO) plans often offer lower premiums and are suitable for those who stay in a specific network area. On the other hand, Preferred Provider Organization (PPO) plans have wider networks and are better for frequent travelers.

Cost Comparison

Compare the costs of different insurance plans, including the premiums, deductibles, and out-of-pocket maximums. Evaluate the financial implications of being covered under separate insurance plans versus a joint plan. Factor in any employer subsidies and the potential impact on your monthly budget.

Provider Networks

If you wish to continue seeing your current healthcare providers, ensure that they are included in the network of the insurance plan you choose. Check the provider directories and match them against the plans you are considering.

Understand Your Needs

Assess your own health needs and those of your spouse. Consider any chronic conditions, anticipated medical expenses, or specific requirements. Opt for a plan that offers suitable coverage for both of you and provides access to the necessary healthcare services.

Seek Professional Guidance

Insurance can be complex, and it's easy to feel overwhelmed. Reach out to insurance representatives or experts who can guide you through the process. They can help you understand your options, answer your questions, and ensure you make a well-informed decision.

Remember, combining health insurance plans is usually a cost-saving strategy, but it may vary depending on individual circumstances. Take the time to carefully review your options, ask questions, and choose a plan that best suits your needs as a couple.

Frequently asked questions