Just Married? Health Insurance for Your Spouse & You

Congratulations! This stage of your life comes with many new and exciting choices, but there's also some decisions to make when it comes to the business side of being married. For example, like setting up your health insurance.

In most cases, individuals and families can only purchase a new health plan once a year during open enrollment. However, marriage or domestic partnership is considered a qualifying life event. That means you and your new partner — as well as any children in your new family — can now qualify for a special enrollment period to get or change coverage.

Your Health Insurance Options

If one of you already has health insurance through your employer, you may be able to add your spouse, partner, or dependents to that employer-sponsored plan. Remember: Small businesses and part-time employers are not legally required to offer health insurance. Large employers are legally obligated only to offer coverage to employees and their dependents — but not their spouse or partner.

If employer-sponsored coverage isn’t available, explore your options with Covered California, a free service from the state that connects Californians to brand-name health insurance as well as financial and enrollment help for those who need it. As a newlywed, you qualify for a special enrollment period. That means you can enroll in a health plan within 60 days of your marriage or partnership. If you’re already an enrolled member, you can also use this time to add your spouse, partner, or dependents to your coverage or choose a new plan.

Keep in mind that if your household size or income has changed due to your union, your eligibility for financial help may also change. As with any other life change, if you are already enrolled in a health plan through Covered California, you’ll need to report it.

Your Health Plan Options

If both of you currently have health insurance, start by comparing the details of each plan side by side. While many partners choose to be on the same health plan, consider what’s best for each of you separately and together as a family.

When comparing plans, add up your out-of-pocket costs. How much is your and your spouse’s current coverage costing each of you individually? What about your dependents? It’s important to realize that if a family is spread across different health plans, each plan has its own out-of-pocket limit. When weighing coverage options, look beyond the combined costs of monthly premiums alone. Check what the yearly deductible and out-of-pocket limit are for both individual plans and a family plan.

Be sure to take health care preferences into account as well. Look at how much choice in health care providers each plan offers and whether your current primary care physician and specialists are in the network of any other plans you’re considering.

If one partner is healthy and the other needs a lot of medical care, it might make more sense for you to have separate health plans. The healthier partner might choose a lower-costing plan with a higher deductible, while the partner with more medical needs might select a higher-costing plan with a lower or zero deductible. Your monthly statement should include information on how much you’ve paid to date toward your deductible and how close you are to reaching your out-of-pocket maximum to help inform your decision.

Sign Up Now

Whatever you choose, it’s important to make sure your entire family is covered. As of 2020, in California, having health coverage is also the law, and you’ll pay a penalty come tax time if you go uninsured and don’t qualify for an exemption.

Remember, you have 60 days from your marriage or partnership to enroll in or make any changes to your health insurance plans. People with low incomes of up to 150 percent of the federal poverty line, or those who qualify for Medi-Cal, can apply year-round.

Visit Covered California to apply for health insurance today. If you have questions or need assistance, free expert help is available.