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Should married couples combine health insurance?

Marriage discussions should include practical matters such as health insurance — whether to maintain separate policies or combine plans.

Newly married couple discussing single vs. married health insurance

Whether or not you and your spouse should combine health insurance doesn’t exactly inspire thoughts of romance, but it’s an important topic for any about-to-be-married or married couple to discuss. About one-third of couples opt for separate plans — but that also means over two-thirds share the same health insurance. Your doctor preferences, medical needs and out-of-pocket costs are just a few of the important considerations in healthcare plans for couples. Use this conversation guide to get started in understanding the difference between single vs. married health insurance.

What health insurance options are available to you?

Many people are offered a variety of health insurance options through their employer. Others may be more limited in their choices. For example, a self-employed individual seeking individual insurance may find that they have fewer options to choose from and, often times, those options are more expensive. In such instances, it may make sense to explore one spouse’s healthcare plans if offered through their employer to see if a more comprehensive and/or budget-friendly option is available.

What are your medical needs?

An individual with a specific health condition, particularly one that’s chronic, may have a greater need than their spouse for expanded or specialized services. In that case, it’s important to weigh the options available to decide if it makes more sense to combine your health insurance plans as a couple or keep separate individual plans. If one spouse has fewer medical needs, it may benefit them more not to combine their health insurance.

Is combining health insurance helpful toward meeting a deductible?

According to 2020 regulations, no family may pay more than $16,400 for out-of-pocket costs, and that includes multiple family members on one policy, so it may make sense to combine health insurance plans if it helps you more easily reach that out-of-pocket maximum where insurance pays 100 percent for covered services. Otherwise the total will apply to each separate policy.

Is there a health insurance spousal surcharge?

Nearly 90 percent of employers that offer health insurance also offer spousal coverage, with some caveats. Some may only offer coverage if the spouse doesn’t have their own employer option. Others — over 30 percent of companies in fact — may charge a premium to add a spouse, while some may reimburse an employee who enrolls in their spouse’s plan instead.

Taking all of these factors into consideration – available options, medical needs, costs, etc. – can help you determine which choice is best for you and your spouse.

The information in this article was obtained from various sources not associated with State Farm® (including State Farm Mutual Automobile Insurance Company and its subsidiaries and affiliates). While we believe it to be reliable and accurate, we do not warrant the accuracy or reliability of the information. State Farm is not responsible for, and does not endorse or approve, either implicitly or explicitly, the content of any third party sites that might be hyperlinked from this page. The information is not intended to replace manuals, instructions or information provided by a manufacturer or the advice of a qualified professional, or to affect coverage under any applicable insurance policy. These suggestions are not a complete list of every loss control measure. State Farm makes no guarantees of results from use of this information.




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