Different Health Insurance Plans for Married Couples
You've just landed your dream job and along with it, the opportunity to take advantage of your new employer's health insurance. But you might be wondering if you and your partner can have different health insurance plans.
Here are some tips to help you ask your new employer questions and evaluate your present coverage to ensure that you're maximizing both care and premium dollars while minimizing overall costs.
Questions to Ask Your New Employer
As you begin to review your benefits package, ask your new employer's benefits administrator for details about their health plan. Digging into the plan's details will help you and your spouse determine if one or both of you will switch over to your newly available plan. Here are questions to ask so you can weigh your options with confidence:
- What Is the Policy for Spousal Coverage? While there are always options for an employee to add dependent children, there are some instances where employers only offer spousal coverage if the non-employee spouse is not eligible for coverage through their employer.
- What Are the Terms for Spousal Coverage? While many employers make a significant contribution to the employee's coverage, they may not offer any incentives for spousal coverage. This could mean higher premium costs to add a spouse to the new plan.
- Is There Additional Compensation If You Add Your Spouse? When new employees opt to be insured through the non-employee spouse's health plan, some companies will offer a compensation boost.
- What Detailed Premiums, Deductibles, and Coverages Are Offered? As you explore your new coverage options, be sure to make a side-by-side comparison of coverage between each spouse's plan. This will help determine if coverage that is essential to your health needs (such as in-network specialists, coverage for chronic conditions, etc.) is better through the new plan or with an existing plan.
The next step is determining whether you should have different health insurance plans.
Different Health Insurance Plans
There are several reasons you and your spouse might opt for separate plans. Here are a few to consider:
- Premiums: If it costs less for each spouse to be on separate plans without compromising coverage.
- Physicians: If separate plans offer each spouse access to specialists or primary care physicians of choice and help you avoid changing physicians.
- Chronic Medical Conditions: If changing plans would cause a spouse to lose access to ongoing care with an established hospital or care group.
By doing the research and making side-by-side plan comparisons, you and your spouse can see if separate plans offer you the ideal coverage scenario for your health and finances.
The Same Health Insurance Plan
After crunching the numbers and comparing plans, you might find that it makes better sense for both of you to be on a single plan — whether that's a new plan or your existing plan. Here are some scenarios where being on the same plan might be the best decision:
- Employer Contributions: If one employer offers significant contributions toward spousal premiums, lowering overall costs.
- Lower Projected Out-of-Pocket Expenses: If both spouses have significant projected health costs because of ongoing conditions or needed care, a single plan could reduce annual out-of-pocket expenses.
- Health Savings Account (HSA) Options: If you have family coverage through an HSA-eligible health plan, you and your spouse could max-out the annual contribution instead of being limited by having one HSA plan and one non-HSA plan.
Whatever course you choose, having options when it comes to healthcare is always a plus. Your company's benefits administrator can always help answer detailed plan questions so you and your spouse can make the most informed decision.
