Adding a new spouse to your health insurance is a wise choice, especially if you receive benefits through your employer. In fact, some couples factor insurance perks into their decision to get married in the first place. What many people don’t know is that insurance providers offer a special enrollment period of only 60 days to add your new spouse to your policy.
As its name suggests, the reality show Married At First Sight features couples who get married, sight unseen. In a recent episode, one spouse (Miguel) refused to add the other (Lindy) to his insurance policy right away, preferring instead to wait until the show was over, which was 56 days after they got married. In reality, this would give Miguel only four days to add Lindy to his plan.
Getting married counts as a qualifying event when it comes to insurance benefits. Explore the best coverage options and their respective enrollment deadlines, for you and your spouse.
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How Long Do You Have to Add Your Spouse to Your Health Insurance?
Most plans require policyholders to add their spouse within 60 days of getting married. Since marriage (verified by a government-issued marriage license or certificate) denotes a life qualifying event, newly married couples enjoy a unique enrollment period of two months after tying the knot. After 60 days, policyholders must wait until the next open enrollment period to add their spouse.
How Do You Add Your Spouse to Your Health Insurance?
Marriage qualifies policyholders for a special enrollment period, so you can add your spouse within 60 days of getting married. Spouses most commonly experience one of the following scenarios before joining their partner’s plan:
You Both Already Have Private ACA Health Insurance
Your spouse is included in your “household” if you file taxes jointly as a married couple. During your special enrollment period, you may add your spouse to your household and browse options for ACA plans that cover both of you, and opt out of your respective former plans.
You Both Already Have Employer-sponsored Group Health Insurance
If you both receive benefits through your respective employers, you should consider which one offers the best coverage for your needs. For example, you should make sure the plan you choose includes the preferred providers of both you and your spouse. One of you can decline their employer-sponsored coverage, or you can both add spouses for dual coverage plans.
If you are both dual enrolled in one another’s plan, you would have coverage under both plans. This can ensure that you have access to a wider range of medical services and treatments. For example, if one spouse’s plan doesn’t cover a particular service or treatment, the other spouse’s plan may offer coverage.
Your Spouse Is Not Insured
You can add your spouse to your employer-sponsored health insurance or ACA plan if they do not currently have private insurance or recently lost their own employer-sponsored coverage. This requires notifying your employer’s HR department of the addition or reporting a life change to your private ACA plan.
Most employers and Marketplace providers allow you to add your spouse during the special enrollment period of up to 60 days after you get married. You may also add them during open enrollment.
Adding a Non-U.S. Citizen Spouse To Your Health Insurance
The reality show 90 Day Fiancé highlights the experience of couples that include a non-citizen traveling to the U.S. on a visa. Half of all couples on the show fall in this category, which presents multiple challenges, including finding and securing healthcare coverage. 90 Day Fiancé brings to light the struggle of couples with mixed citizenship to claim benefits in the U.S.
The Affordable Care Act (ACA) guides national healthcare policy and oversees the Health Insurance Marketplace. While you don’t have to hold full U.S. citizenship to enroll in an ACA plan, you must be “lawfully present,” which includes:
- Immigration “qualified non-citizen” status, with no waiting period
- Humanitarian status, such as asylum applicants or victims of trafficking
- Valid non-immigrant visa status
- Legal status conferred by other laws, such as LIFE Act or Family Unity
“Lawfully present” status refers to a person who does not hold American citizenship but resides lawfully in the U.S. under one of a variety of qualifying circumstances. Examples include green card holders, asylees, and refugees. Most insurance companies require “90 day fiancés,” or spouses with a K1 visa, to be married for at least a year before they can be added to a policy.
However, some states offer additional health insurance options for non-residents. For example, in California, anyone with residency in the state can apply for Medi-Cal coverage. This means those on a K1 visa would not necessarily need to wait for a year before gaining health insurance coverage if they meet other Medi-Cal eligibility requirements.
But Why Should You Add Your Spouse to Your Insurance Anyway?
Even if they have another viable option for healthcare coverage, adding your spouse to your insurance can save time and money under the right circumstances. The following are among the most significant benefits of adding your spouse.
- Financial savings: In some cases, adding your spouse to your insurance and combining the cost of coverage can collectively save you money in the long run. For example, adding your spouse to your employer-sponsored insurance policy may raise your monthly premiums but still cost less than paying for two separate plans.
- Better coverage: Even if your spouse is eligible for a private ACA plan or has their own employer group coverage, your plan might offer higher-quality healthcare options. Most major insurance providers offer top-notch benefits for spouses, dependents, and, in some cases, common-law partners.
- Consolidation of claims and paperwork: Tracking claims and saving important documents is easier when you only have one plan to manage instead of two. Most insurance providers allow customers to register their account in an online patient portal to consolidate all of their important information in one place.
When Love Is Blind: How to Remove a Spouse From Your Health Insurance
Once you add your spouse to your health insurance, you may only remove them during the next Open Enrollment Period, which usually runs from November 1 until January 15 the following year in most states. Insurance companies offer a special enrollment period for adding your spouse within 60 days of getting married; however, there is no special enrollment period granted for divorce.
To try to change coverage between enrollment periods, policyholders could try contacting their insurance company to remove their spouse once they have legal documentation of their settled (closed) divorce case. Notify the insurance carrier of the date of your divorce and request this change in coverage. For employer-based plans, you may notify HR and complete a self and family form (SF 2809) to change to self only coverage. However, insurers may still mandate that you wait until the next enrollment period to make changes.
In Sickness and In Health: Stay Insured to Protect Your Union From Unexpected Medical Costs
While individual options may vary, you and your spouse should maintain health coverage at all times. Otherwise, your or your spouse could fall prey to costly medical expenses and/or inadequate medical care. In some cases, adding a spouse can provide them with otherwise inaccessible healthcare coverage.
You and your spouse may already have separate insurance policies or your spouse may not hold U.S. citizenship yet. Your ACA or employer-funded healthcare plan may cost more than self-only coverage but save you money on your monthly premiums, overall. Additionally, adding a spouse to your policy can offer them higher-quality benefits if your plan features more comprehensive coverage.