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Guide for Adding Your Spouse to a Health Insurance Plan

Posted: June 26, 2024

Couples may each have their own health insurance plan, or, in some cases, only one of the spouses may have a plan. In either case, sometimes it makes sense for one partner to add their spouse to their plan. Adding your spouse to your health insurance plan is not difficult. In this guide for adding your spouse to a health insurance plan, you’ll learn how to do this stress-free.

How You Can Add Your Partner to Your Health Plan

Different scenarios require different approaches when you want to add your spouse to your health plan. Overall, there are three main options you can use to add your spouse:

  • Consolidating your plans: If you both have individual plans under different employers, you may be able to consolidate your health insurance plans under one employer. This approach usually leads to higher premiums. You may have to consider the pros and cons of the two plans before settling on the one to consolidate. You may also want to consider how much it costs to add your spouse to health insurance.
  • Add spouse to existing employer plan: If only one of you is covered, it’s easy to decide because you only have one plan to consider. U.S. laws require insurance companies to allow you to add dependents during special life events.
  • Buy via the Marketplace: People without employer coverage, Medicare, the Children’s Health Insurance Program (CHIP) or Medicaid can purchase insurance via the Health Insurance Marketplace. Suppose you have employer coverage that doesn’t meet specific minimum requirements and believe that adding your spouse to your health insurance may require expanded coverage. In that case, you may be able to purchase health insurance on the Marketplace, but you’ll have to pay the full price.

Can You Add a Spouse to Health Insurance at Any Time?

You can add your spouse during open enrollment, which occurs annually from November 1 to January 15. During this period, you can sign up for insurance or update your existing plan. If you have employer coverage, your employer sets the open enrollment dates. Adding your spouse is one of the changes you can make during this enrollment period. However, you don’t always have to wait for the open enrollment period to add your spouse.

Certain life events qualify for a special enrollment period (SEP), during which you can change your health insurance plan outside the open enrollment period. SEP is the best time to add your partner to a health insurance plan because you will not lose coverage by waiting for the open enrollment period. Qualifying life events include:

  • Marriage
  • Divorce
  • Having a baby
  • Change or loss of employment
  • Adopting a child
  • Placed a child for foster care
  • Household income is below a specific amount
  • Moving to a new ZIP code or county
  • Lost health insurance
  • Death

These events are spontaneous, meaning the special enrollment period can happen anytime. You can enroll in a plan 60 days before or after the event.

Adding Your Spouse to Your Health Insurance After Marriage

Adding your spouse to health insurance after the marriage is possible in all states. Marriage is one of the qualifying events under SEP, but you’ll have to add your spouse within 60 days after the marriage. Outside this day window, you must wait for the open enrollment period to add them.

The steps for adding a spouse to an insurance plan are easy. You’ll need their personal information, such as their social security number and date of birth. Your employer may also require you to provide a copy of your marriage certificate. You must then fill out an enrollment form to add your partner. There are three main ways to include your spouse in health insurance.

Can You Add Your Fiancé to Your Health Insurance?

In most states, you cannot add your fiance to your health insurance until after you marry. However, California allows you to add a long-term domestic partner. A domestic partnership happens when two people in a committed relationship live together. Domestic partnerships are not recognized by federal law.

Your employer may provide health insurance if you’re in a domestic partnership, and the coverage is similar to that of a married couple. Your employer or insurance company may ask for proof of your domestic partnership.

Factors to Consider When Choosing a Health Insurance Plan for Spouses

Consider several factors when deciding on a single health insurance plan to use:

  • Find out if your employer can cover your spouse: Not all employers permit their employees to add their spouses to their employer-sponsored insurance coverage. If neither of your employers provides these benefits, you’ll have to seek alternatives.
  • Compare premiums: Use one health insurance plan for both of you only when it makes financial sense. If you’re both covered and have to choose one, compare the premiums, deductibles, co-payments and plan maximums before making a choice. You should know how much it will cost to add your spouse to your plan.
  • Check if your providers are in the health plan’s network: The provider networks differ if your employers use different insurance carriers. If your current doctor doesn’t accept your spouse’s insurance, you may have to pay out of pocket to continue seeing the doctor.
  • Who has a more stable job: If you have to choose one coverage, selecting the plan for the spouse with a more stable job makes sense. The stability of a job may have different definitions for different people, and it all depends on who both of you agree has more chances of staying at the job in the long term.

Reach out to Health for California for Help

Adding your spouse to your health insurance plan is not a difficult process. At Health for California, our platform is easy to use, and you can apply for any type of insurance you need. Please get in touch with our team for help.