Health Insurance and Marriage

Health Insurance and Marriage

“I am Recently-Married. Should I Transfer Under My Spouse’s Health Insurance Plan?”

Life events, besides being milestone markers in our lives, are also appropriate times to evaluate changes to your lifestyle and household options, including your new health insurance options and needs. Marriage, though not as dramatic a change to lifestyle and personal budgets as the birth of a child, presents an opportunity for re-examination of healthcare options, costs, and needs for you and your new spouse. The Health Insurance Portability and Accountability Act identifies a 30-day special enrollment period from the day of your marriage in which to notify your health insurer of changes to your coverage. How will you know what to do, if anything? To take advantage of this, you must understand what to evaluate and determine which option works best for you. Here are some key considerations to help guide your decision:

Premiums / Deductibles / Co-Pays

The most compelling reason to transfer plans is financial. Some employers provide health plans that require less out of pocket expense, and a simple comparison of benefits from your respective employers could show a significant savings by transferring to your spouse’s plan. This information is readily accessible through your provider’s website or your company’s HR group.

Network Coverage

Many people value their comfort level with their doctors. If you are one of these, you should take a quick look into whether your primary care physician and any specialists that you may see regularly are “In Network” under your spouse’s plan. If they are not, then transferring is likely not the best course of action.

Specific Care Coverage

If either of you or your dependents suffer from a specific recurring illness or chronic condition, such as allergies or mental health issues, it is well worth researching whether your spouse’s health plans provide specific coverage for your condition. By transferring health plans, you may reap immediate financial relief for these expenses.

Ultimately, the best decision is what fits your needs. You may determine that status quo on health insurance plans is the best situation for you and your spouse. This is not a one time evaluation; employers update their health benefits annually, and taking the time to compare coverages going forward will help to ensure your family will have the best coverage at the right price.