Adopting a spouse onto your health insurance can require specific documents. While the process varies depending on your employer and insurer, in general the process should be straightforward.
Addition of your spouse can be done during open enrollment or upon experiencing a qualifying life event such as getting married or losing other coverage. Be sure to know all deadlines and requirements so you can plan accordingly.
Adding a Spouse to an Existing Policy
Process for adding a spouse to an existing health insurance policy varies depending on your current situation. As the first step, review your plan and requirements of your employer or insurance company before considering how best to submit any changes, as deadlines for submission can differ between plans and insurers. Speak to your partner regarding what kind of plan they would prefer as well as any physicians they are seeing before making this decision.
Most insurance plans permit adding a spouse during annual enrollment or shortly after marriage, depending on your current circumstances. Some plans, however, require qualifying life events such as getting married, losing your job or having a child before making changes; doing so allows for quicker underwriting approval processes without underwriting requirements imposed on individuals with regards to health history and coverage needs.
If you want to add your spouse as a dependent, enrolling through either the health insurance marketplace or employer open enrollment period is required. Both parties will need to answer questions regarding income and household information during open enrollment in order to determine how much each must pay and which plans are available.
Note that if you add your spouse to your plan who already has their own insurance plan, they could incur an additional surcharge. Most employers offer discounts to employees who join their spouse’s plan, though this may not always be available.
Marriage brings many things together: hearts, households and finances. Additionally, it qualifies as a qualifying life event that allows you to make changes to your health insurance outside of its annual enrollment period. Whether it be keeping an employer-sponsored plan, adding your partner on, or enrolling through the marketplace; be sure to carefully consider all options when making this important decision.
Adding a Spouse to a Marketplace Plan
Once married, Marketplace plans provide an easy way for spouses to join your plan – provided it’s during an open enrollment period or the next open enrollment period is open for enrollment.
Dependent upon your situation, it may be more cost-effective for both of you to be on one insurance policy. Conduct a cost-benefit analysis; compare each spouse’s current premium costs against those associated with your joint plan premium and factor in any doctors or clinics only within one spouse’s provider network; these providers may charge more when providing out-of-network care.
If both spouses are employed, you may opt to sign up for each company’s health insurance plans separately. If either employer offers a QSEHRA or an ICHRA plan, switching plans outside the annual open enrollment period may be allowed; however, your employer or sponsoring company may require documentation proving eligibility – for instance a copy of your marriage license/certificate and letter from previous employer that coverage has been discontinued could be necessary as proof.
Transferring your work-based health insurance coverage onto that of your spouse can be tricky, though the government has made this possible. While the rules will differ between employers and insurance companies, most will allow for this during an open enrollment period if an event qualifies as qualifying – like getting married or losing another type of coverage; timeframes for changing plans will be determined by either them or you as the employee/insurer respectively.
Adding a Spouse to an Employer-Sponsored Plan
Your life with your spouse includes many beautiful aspects – a home, a family and love are among them – but there may also be less romantic things like bank accounts, bills and health insurance plans that you share. Most employers and insurance providers allow employees to add their spouse to employer-sponsored plans; the exact process varies by employer and insurance provider. Typically, however, proof of your marriage such as copies of marriage certificate and tax return forms is necessary in order to add them.
Sharing healthcare costs with your spouse may help lower healthcare expenses, particularly if you choose a plan with lower co-pays. But before signing, it’s essential that both of you discuss all available options to find what’s right for both of you – it could even be cheaper to each have separate plans if some of your doctors are unavailable in their network.
Before adding your spouse, be sure to carefully consider both costs and network coverage. Some employers may charge an extra surcharge if your spouse purchases their own coverage; it’s also wise to think through your medical history as well as what type of protection both of you require; if either party has preexisting conditions it may be wiser for them to obtain their own policy from either marketplaces or employers rather than joining your current policy.
Keep in mind the stability of each of your jobs when considering adding your spouse. A job change could qualify as a special enrollment period and give you an opportunity to add them, although be careful as switching over outside open enrollment could prove challenging or impossible.
In these instances, you’ll have to wait until the next open enrollment period for coverage – or apply for special enrollment periods if available – in order to include your spouse on your plan. Otherwise, they could pay additional premiums in order to remain part of it.
Adding a Spouse to a Family Plan
Your decision on whether or not to add your spouse to your plan depends on various factors, including cost and benefits considerations. For instance, if both of you are covered under an employee plan it might make more sense to combine plans in order to save both time and money – just be sure that all of your doctors are included as provider networks in both companies’ networks! Additionally, make sure you remember open enrollment periods since each employer may only give a certain window of time in which to switch back from “employee & spouse” coverage back into coverage “employee only”.
If either spouse is self-employed, it may be more cost effective to remain on their individual plans. When selecting the ideal plan for yourself and your partner, take time to compare each benefit carefully – spending some time understanding how each plan works will save time and money in the long run!
Your spouse’s coverage can typically only be modified during an open enrollment period or following a qualifying life event – typically this means welcoming a newborn into the family, losing coverage through employment or getting married.
No matter the policy type you purchase, most insurers require some form of documentation to verify eligibility for coverage. This typically includes your most recent federal tax return (with all financial data removed), marriage certificate and proof of joint ownership/residency such as bank/mortgage statement/property taxes/lease agreements etc.
On the Marketplace, you must submit a new application and answer all applicable questions regarding income and household size. In addition, forms and documents specified by your insurance provider will likely be necessary; sometimes marriage certificates and birth certificates of children being added may even be requested as required documents.
