spousal health insurance

You have options if you’ve lost health insurance coverage because of a job loss or another unforeseen life circumstance. Many employer-sponsored health insurance plans allow spouses to get coverage, so you might be eligible for spousal health insurance through your spouse’s health plan. Here are some common questions about spousal health insurance coverage.

What Is Employer-Sponsored Spousal Health Insurance?

Employer-sponsored spousal health insurance is coverage that’s available through your spouse’s plan. In fact, 71% of American couples share the same insurance plan, according to a 2019 Morning Consult-CNBC Make It poll.

Can an Employer Deny Spousal Health Insurance?

Yes, employers can deny spousal coverage. U.S. employers do not have to offer health insurance to their employees’ spouses. The Affordable Care Act (ACA) says that employers can choose to offer coverage for employees and their dependents, which can include a child or other qualifying relative an employee claims on their annual tax return—but not spouses. In fact, 11% of employers offering health plans do not allow spouses to enroll if they have coverage from another source, according to a 2019 report.

Per the ACA, companies with 50 or more employees are only required to offer health coverage to their full-time employees. This can also include a full-time employees’ dependents.

Are Employers Required to Offer Health Insurance to Domestic Partners?

No, employers are not required by federal law to offer health insurance to domestic partners, even if they offer spousal health insurance coverage. Health insurance benefits for domestic partners vary by state, municipality, and company. A domestic partner is defined as someone who:

  • Is in a committed relationship with the employee,
  • Shares the same residence as the employee, and
  • Is not married or joined in a civil union with another person.

How Can I Get on My Spouse’s Insurance Plan?

If your spouse’s company allows it, you can get on your spouse’s insurance plan by asking your spouse to speak to their company’s human resources department for further details. For example, you may need information such as which documents are required (copy of marriage certificate, Social Security card, birth certificate, etc.) to complete an enrollment form for spousal coverage.

How Long Do I Have to Get on My Spouse’s Employer-Sponsored Health Insurance?

You have 30 days to get on your spouse’s employer-sponsored health insurance if you have recently lost your job and health insurance. Losing your job-based health insurance is considered a “qualifying life event” under the Affordable Care Act (ACA). In this circumstance, you could find coverage on your spouse’s health plan and enroll within 30 days. If you miss this window, you’ll have to wait until the next Open Enrollment Period (OEP) to switch to a spouse’s health insurance or purchase an individual health insurance plan.

How Much Does It Cost to Add a Spouse to Health Insurance?

The cost to add a spouse to an employer-sponsored health insurance plan can vary by plan and company. Here’s what to consider when thinking about making a switch to a spouse’s health insurance.

    • Pro:Being on one plan could potentially save you money: 13% of employers provide additional compensation or benefits to employees if they enroll in a spouse’s employer-sponsored health insurance plan.
    • Con: However, 11% of employers offering health plans do not allow spouses to enroll if they have coverage from another source. Also, 33% of large employers impose a fee for spousal health insurance, and the average spousal surcharge is $1,200 a year. Additionally, 10% of employers require spouses to pay more through a larger premium or higher cost share.

When considering spousal health insurance, it’s best to review all the potential costs because additional fees could cancel out any savings you may get.

If you’ve recently lost your job and need health insurance, HealthMarkets can provide counsel on health insurance for married couples or domestic partnerships. Review all your coverage options, and find the right fit for your needs.

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References

https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/ | https://www.kff.org/report-section/2018-employer-health-benefits-survey-section-2-health-benefits-offer-rates/ | https://www.kff.org/health-costs/press-release/benchmark-employer-survey-finds-average-family-premiums-now-top-20000/ | https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/employers-adjust-health-benefits-for-2019.aspx | https://www.cnbc.com/2019/11/08/29-percent-of-couples-have-separate-health-insurance.html | https://www.cnbc.com/2020/03/18/how-to-find-health-care-coverage-if-youve-lost-your-job.html | https://www.opm.gov/faqs/QA.aspx?fid=3f64bd3d-1107-44e7-9962-c8b652848f14&pid=9481b29e-6294-46d3-8023-1e6769f8ebd1 | https://www.healthcare.gov/glossary/domestic-partnership/ | https://www.healthcare.gov/glossary/dependent/ | https://www.investopedia.com/terms/d/dependent.asp

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