Does tying the knot also mean you should say “I do” to your partner’s health insurance?
The short answer is that … it depends. The best health insurance for married couples can vary based on the plans your respective employers offer.
Ready for the long answer? Here’s how to weigh the pros and cons of going on your partner’s health insurance or adding them to your own.
Find Out Whether Combining Your Insurance Is Possible
If you and your spouse have different employers, make sure you understand your own employer’s policy for spousal coverage. Some employers don’t allow you to add your spouse if they already have access to a health plan through their work. Other employers will allow you to add your spouse, but doing so may come with an additional charge, along with a higher monthly premium for family coverage.
If you’re in a domestic partnership, it’s important to find out how your state recognizes domestic partnerships and how this may affect your insurance coverage. In some states, you may have to sign an affidavit to confirm you’re eligible for domestic partner health insurance.
So talk to your HR department to find out if your spouse is even allowed on your plan — and what it could potentially cost you every month.
Consider Your Deductible and Out-of-Pocket Maximum
Having two separate health plans means you and your partner will individually have to cover out-of-pocket costs like deductibles, the amount you pay for health care costs until your insurance kicks in to cover expenses.
Separate plans also mean you’ll have separate out-of-pocket maximums, which is the highest annual amount you could be responsible for paying for your care. Hitting the out-of-pocket maximum is often easier to do as a family, especially if you or your partner have ongoing medical needs. Look around at some plans and crunch the numbers — a single policy that covers your entire family could be more affordable than two individual policies.
Talk About Who Has Better Insurance
Compare your health plans to see which partner has better health insurance. What’s right for your family will depend on your medical history and personal health, but pay attention to things like provider networks, higher deductibles, higher out-of-pocket maximums and the percentage your insurance covers for various medical services like surgery, outpatient procedures and inpatient hospital stays.
A policy that has a wider provider network or doesn’t force you to switch doctors, for example, may be a better option for your needs than one with a more restrictive network. On the other hand, a plan with a smaller network might be worth it if it has lower out-of-pocket costs. There’s no universal answer for what makes a good health plan, so decide what your priorities are — for instance, do you care more about having a lower deductible or a lower monthly premium? — before making any decisions.
Look at Supplemental Insurance Options
Whichever partner’s medical plan coverage you consolidate coverage into, you might find that some of your needs aren’t covered. In these cases, it might be worthwhile to consider enrolling in supplemental insurance, such as a fixed indemnity, critical illness or accident insurance plan.
These plans provide a cash payout if you ever have an accident, are injured, have to stay in a hospital or find yourself in another qualifying medical situation where an extra influx of cash could come in handy. Each plan covers different needs, and the payout can go toward more than just hospital bills. If you can’t work after an injury, for example, a payout from a critical illness plan can help replace some of your normal wage. All of these policies can reduce your out-of-pocket costs and cover health insurance gaps you may have after enrolling in a single policy for your family.
Figuring out health insurance for married couples can sometimes be tricky, but if you do a little research, talk to your HR representative and compare costs, you can find a way to give yourself and your partner the health care coverage you need at an affordable cost.