Just Married? Let’s Talk Health Insurance
Key Takeaways
- Getting married is considered a Qualifying Life Event (QLE)Qualifying Life Events (QLE) are life changes that allow you to enroll in a new health insurance plan during a Special Enrollment Period. These include having or adopting a child, losing other coverage, marriage, a change of income and moving. and allows you and your spouse to make health plan changes for 60 days following your wedding.
- Before determining if you and your spouse should be on the same health plan, consider your options and the implications.
- Think about your individual health care needs and how the plans available to you accommodate them.
- Talk openly about if and when you will expand your family.
- Look into employer-sponsored health plans if they are available to you or your spouse.
Congratulations on your Qualifying Life Event!
Okay, so maybe that wasn’t on any of the cards you received on your big day. But did you know that getting married is considered a Qualifying Life Event (QLE)?[i]
A QLE means you and your spouse have a unique opportunity to enroll in health coverage outside of Open Enrollment. You and your spouse have 60 days from your wedding day to decide if you want to purchase joint health insurance (a “family plan”) or rather stay on two different plans.
Still have questions? GoHealth has the answers you need.
Making Sense of Your Options
Before automatically assuming that the old marriage adage “what’s mine is yours, “ consider all factors before making a purchasing decision.
Here’s a quick breakdown of your options:
- You are purchasing two individual health insurance plans from a marketplace, one for each of you.
- You are purchasing one family health insurance plan from a marketplace, one that will cover both of you.
- If applicable, remaining on two separate existing employer-sponsored health plans.
- Adding one spouse to the other spouse’s existing employer-sponsored health plan, one that will cover both of you. (Note: employer-sponsored health plans require QLE changes within 30 days of the QLE.)
Take Time to Consider All Angles
Chat about your health histories and health care needs
Maybe you didn’t exactly talk about your detailed health histories while you were dating and engaged —but now is the time to lay it all on the table. Knowing about family histories, certain risk factors, and both current and future health care needs will help you and your spouse make a sound decision on how to move forward.
If one of you is generally healthy and the other may require higher levels of medical care, it may make more sense financially to be on two separate health insurance plans.
Consider asking these questions to guide your conversation:
- Does either of us take regular prescription medications?
- Does either of us require regular office visits to specialists? Think psychiatrist, endocrinologist, allergist, physical therapists, etc.
- Will either of us require any medical procedures in the foreseeable future?
- Do either of us smoke or participate in any other behaviors that could contribute to health issues in the future?
Don’t shy away from the baby conversation.
Has it happened yet? Has your great aunt started dropping hints about it being time to expand your family? We know, we know — you haven’t even unpacked from the honeymoon yet. But here’s the truth: Knowing if and when you and your spouse are planning on adding kids to the equation will influence your health insurance decision.
Suppose you’re planning on growing your family (by birth or adoption) immediately. In that case, it makes sense to consider a plan’s coverage for certain things like maternity and newborn care, inpatient hospital stays, and pediatric visits.
Look into your employer-sponsored coverage
One or both of you may have access to a group health plan through an employer. Employer-sponsored coverage can be an affordable option for families who do not need to customize their coverage to account for specific healthcare needs.
If you or your spouse have employer-sponsored health insurance, you may add your spouse but will need to do so within 30 days of your wedding date.
Find the Medicare Advantage plan that meets your needs.
FAQs
Can I and my spouse have two different plans?
Do I need to elect all new benefits when I add my spouse?
Sources
- Qualifying Life Event (QLE). Healthcare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.