So you finally tied the knot. Congrats!
You and your spouse are already busy combining your assets and your furniture (so it’s time to throw out that old futon you bought in college). Now, you find yourself asking: “Should we be covered by the same health insurance plan?”
It’s a good question, without an easy answer. It’s not necessary for married couples to have the same health insurance plan, but under some circumstances, it’s the most economical choice. Let’s talk about it.
It’s usually better to have separate plans when:
You each have good plans through your employers.
Generally, if both of your places of work offer health insurance plans at a price point that works for you, it’s probably cheaper to remain on those plans. Your employer generally pays a portion of your monthly premium, but they’ll pay out less for spouses.
One spouse has health issues that require them to visit the doctor often, but the other spouse is generally healthy.
The spouse that visits the doctor less can choose a high-deductible, low-premium plan while the other spouse can choose a plan that covers their needs.
It’s usually better to have a joint plan when:
You’re both in good health and don’t use the plan often.
You may be able to save money by choosing a family plan with a high deductible. You could then split the monthly premium between you.
You want to reach your deductible quickly.
Both couples’ doctor visits count toward the deductible, and no family may pay more than $16,400 for out-of-pocket costs.
One of your employers offers spousal coverage.
Circumstances for this vary. Some employers may only offer spousal coverage if the other spouse’s workplace doesn’t offer insurance. Some companies even reimburse employees that join their spouse’s insurance plan.
Still not sure? Let’s do some math.
At the end of the day, you can only know for certain that you’re getting the best deal if you add up the numbers. (It’s a little more complicated than that, but we’ll get there.) First, let’s outline the three possible scenarios that each have their own price point:
You and your spouse have separate health insurance plans.
Your spouse joins your health insurance plan.
You join your spouse’s health insurance plan.
To easily compare these options, let’s line up the different factors contributing to the total amount of money you’ll spend on health insurance in a year.
Premium. The fee that you pay each month to stay covered. If your employer offers a health insurance plan, they often pay a portion of this for the employee.
Deductible. The amount you pay out of pocket before your health insurance plan starts to pay. You pay the carrier’s negotiated price for in-network services until you reach your deductible amount. Typically, the higher your premium, the lower your deductible.
Coinsurance. This is the percentage that your carrier pays for additional medical claims after you meet your deductible.
Copay. This is the amount that some plans require you to pay for certain medical services, such as prescription medication, doctor’s visits, and emergency room visits. These typically don’t apply to the deductible.