Getting Married? When to Switch to a Family Health Care Plan
Shandra Martinez
| 3 min read
Planning for a wedding can feel like a magical time. From picking out dresses and formal wear to carefully selecting items to add to the gift registry – and agreeing on a perfect honeymoon spot – exciting options seem to be around every corner. But there should be some practical decisions in the days leading up to the nuptials, too. Like health insurance. If you’re getting married, how do you know when to switch to a family health care plan?
Single plan vs. family plan. If only one person in the marriage currently has health insurance, then adding a new spouse to the other’s existing health insurance plan is a simple decision. But when both partners have separate health insurance plans, it’s time to dig deeper and see if switching to one plan for both people is a better deal. Here are some factors to consider as you look at each individual plan. The answers to these may make one plan stand out when compared to the other:
- Monthly premiums
- Annual deductible Prescription coverage
- Co-payments
- Out-of-pocket annual maximum
- If your existing doctors accept both insurance plans
How switching to a family plan affects cost. The number of people covered on a health insurance plan does affect what you pay. Your monthly payment typically goes up when you add a spouse to the plan. This is because there are costs associated with each person covered by health insurance. While an individual plan has one member, family plans typically cover two or more members.
Most health insurance plans base their deductibles and out-of-pocket maximums on whether a person is part of an individual or family plan. These numbers for a family plan are typically double of what someone would see on an individual plan. For example, if the deductible is $1,000 for an individual, it might be $2,000 for a family plan. And if the out-of-pocket maximum for an individual plan is $6,000 a year, it would likely be $12,000 for a family plan.
When to switch. There are usually two windows each year when people can make changes to their existing health insurance plans: open enrollment and special enrollment.
- Open enrollment: For 2022 health insurance coverage in Michigan, the open enrollment period is Nov. 1, 2021 to Jan. 15, 2022. People can begin, end or change their health insurance options during this timeframe. Consumers must select a plan by Dec. 15 for coverage to start on Jan. 1. Plans selected Dec. 16 through Jan. 15 will be effective Feb. 1.
- Special enrollment: Certain changes in your life – also called a qualifying event – makes you eligible for special enrollment for health insurance. Marriage is one of these qualifying events.
Generally, you have 60 days from the date of your marriage to make changes to your health insurance plan. You will want to contact your insurance provider for specific information, but here are a few items to have prepared when you are ready to make a switch:
You will probably need at least one of the following documents:
- A marriage certificate showing the date of the marriage.
- A marriage license showing the date of your marriage.
- If you were married out of the country, an official public record of your marriage.
You will also need:
- A Social Security number, or tax ID number, for each person to be covered by the plan.
- A date of birth for each person to be covered by the plan.
- A form of payment, like a credit card, if the health insurance cost is not something that will be deducted from an employee’s regular payroll checks.
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