One of the benefits of marriage is often access to a family health insurance plan. These plans typically offer discounts because they cover more than one person. The most affordable option for a health insurance plan is usually one that is available through one spouse’s employer. However, with the federal, state, and private health insurance marketplaces, there are more health insurance options available to newlyweds who need to buy health insurance on their own.

Navigating the choices available for health insurance when you’re married and picking the best one for you and your spouse can take some research and some understanding of healthcare law. At eHealth, we help married couples in almost every state find the best health plans for their needs and budget. With a wide range of plans available, you and your spouse can choose the coverage that works best for you.

Can married couples have separate health insurance?

Spouses do not have to be on the same plan, which means that if you both have individual plans that you love, there is no reason to lose that coverage. However, you also have the option to be on the same plan, which may be a more economical choice for some couples.

Under the current healthcare law, couples do not have to choose a family plan or the same individual health insurance plan. In some cases, separate policies may be the best option, particularly if you can each enroll in a health plan through your employers. If you both have different health plans, you can compare the following costs to ensure this choice is the most affordable:

• Monthly premiums
• Annual deductibles
• Copayments or coinsurance
• Out-of-pocket maximums

You also want to be sure the plan you choose includes your own doctors in the network, since working with doctors out of a plan’s network is usually more expensive.

Beyond the different employer plans, your options may depend on where you live and your specific family situation. If you are both in good health, you may save the most money with a family health insurance plan. If one spouse has chronic health issues and the other is healthy, couples may save more by choosing a lower deductible plan for one partner and a higher deductible, lower-cost plan for the other.

Is it always an option to be on your spouse’s insurance?

If you are looking for individual or family insurance, you might be curious about whether you can get it through your employer. As of 2023, 95% of firms offered health benefits offer coverage to spouses. 

However, employers are not required to provide spousal insurance. Furthermore, employers are not always required to offer health insurance to their employees at all.

Even though many employers offer subsidized health insurance to attract talented employees, they do not always offer health insurance for spouses. You should have your partner speak to their employer to ask about their health insurance options.

Benefits of being on your spouse’s insurance

There are several reasons why it is helpful to put your spouse on your health insurance when you’re married, including:

• If you get health insurance through your employer, it could help you save money.
• Even if you get health insurance on the marketplace, you could still save a significant amount of money.
• By having your spouse on your health insurance policy, you can reduce the amount of paperwork you have to deal with.
• It will be easier to keep track of your health insurance coverage and benefits if you and your spouse are on the same policy.

Potential drawbacks of being on your spouse’s insurance:

On the other hand, there are a few drawbacks to having your spouse on your health insurance, including:

• There could be a spouse surcharge charged by your employer, which could actually make it more expensive to include them.
• If you lose your job, you and your spouse could suddenly lose health insurance coverage.
• It could make it harder to switch insurance plans if you have your spouse on your insurance policy, as you won’t be looking for a policy for two people instead of just one person.

For these reasons, it is important for you to think carefully about mixing health insurance and marriage.

Can I stay on my parents’ insurance after marriage?

If you have been covered under your parent’s health insurance plan, you might want to keep that coverage after you are married. Under federal law, young adults may keep their coverage under their parent’s plan until they turn 26 years old. This is the case even if you get married before the age of 26. There is also no restriction stating you must continue to live with your parents to keep that coverage.

Can I buy a policy on the Marketplace if my spouse has access to an employer-sponsored plan?

You are not obligated to buy family health insurance from your spouse’s employer. In some cases, a family health insurance plan can be more expensive than a similar plan chosen through a private, state, or federal marketplace.

Keep in mind that 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. For example, you may not be eligible for Obamacare subsidies if you or your spouse have access to an employer-sponsored health insurance plan, but 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.

How does a change in marital status affect my health insurance choices?

If your marital status changes, this is considered a Qualifying Life Event (QLE) and triggers a Special Enrollment Period. During the Special Enrollment Period, you can enroll in an ACA-compliant plan through an employer or on the marketplace or make changes to a current plan. There are different events that may constitute a QLE:

• Getting married
• Getting divorced
• Having a baby
• Suffering a death in the family

The Special Enrollment Period typically extends for 60 days following a QLE. During the Special Enrollment Period, you can:

• Enroll in a new plan, such as a new family health insurance plan
• Add your new spouse to your existing plan
• Join your spouse’s existing plan

If you miss the chance to enroll, you will likely have to wait until the next Open Enrollment Period. In the meantime, you could opt for alternative options like short-term health insurance, accident insurance, or critical illness insurance to provide some coverage in the event of an unexpected accident or illness.

Health Insurance when Married FAQs

Does marital status matter for health insurance?

If you are looking for affordable health insurance for married couples, then your marital status might matter. While many states recognize common law marriages, whether it qualifies you for your spouse’s health insurance policy may vary. In some cases, if you are not technically married, then your employer may refuse to put your spouse on your health insurance policy, as this is an added expense for your employer.

You’ll want to check the terms of your specific insurance options and speak with your employer about whether they allow couples to utilize this option if they are not legally married.

Is it cheaper to get health insurance as a married couple?

In some cases, it could be cheaper to get health insurance as a married couple. There are plenty of options for affordable health insurance for married couples, but the cost of specific health insurance plans can vary depending on the type of plan you choose. That is why you always need to take a look at the details of health insurance plans before you decide to sign up for one, particularly if you are looking for a health insurance plan for you and your spouse.

There are some situations where you might need to pay a spouse surcharge, and there are other situations where employers may not subsidize your spouse as much as they subsidize the employee.

Why do couples have health insurance?

There are plenty of reasons why couples have insurance, including Medicare insurance. The biggest reason why you and your spouse need to have health insurance is that it can help cover the cost of medical expenses. Medical bills can be significant, and health insurance can help you avoid potentially catastrophic financial costs. 

That said, whether you and your partner decide it’s necessary to have health insurance for both of you is a personal decision. Depending on your financial situation and other factors, you may decide that it’s not a possibility at this time.

Does health insurance cover marriage counseling?

Health insurance coverage for marriage counseling varies depending on the insurance plan and the specific circumstances. Some health insurance plans may provide coverage for marriage counseling or couples therapy as part of their mental health benefits. However, coverage may be limited, and certain conditions or requirements may need to be met for the services to be covered. It’s essential to check with your insurance provider to understand the extent of your coverage and any out-of-pocket costs associated with marriage counseling services.

Get insurance coverage with eHealth

Getting married is a huge step in life that includes many life changes and adjustments. When one of those changes includes your health insurance coverage, let eHealth help. Our licensed health insurance brokers can help you navigate a wide range of health plan options to find the one that works best for you and your family. You can enroll in plans via chat, email, or phone at no cost to you or your family. Get started by comparing individual and family health insurance plans in your area today.