Can Married Couples Have Separate Health Insurance?

When it comes to health insurance, there are many different questions that you could be asking. One of the most common questions is whether married couples can have separate health insurance plans. The answer to this question is complicated and depends on several factors, including:

  • Your age
  • Income level
  • Where you live in the country
  • And whether or not you work for yourself

This blog post will explore all these different factors so that you know how to get the best possible plan for your situation!

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Married Couples Can Come Out Ahead with Separate Health Insurance Plans

Before filling out your insurance form, you may want to make sure that the box for your marital status is marked as ‘married’. Though it might seem counterintuitive, there are various reasons why it could be better for you and your spouse to have separate health insurance plans.

7 Things to Consider for Married Couples Before Choosing Separate Health Insurance Plans

1. Deductibles:

Married couples may opt to have individual health insurance plans if they expect high medical expenses. If the goal values, however, couples will need to do some number-crunching and research to find the best combination of plans.

2. Premiums:

Healthcare needs are often out of balance from one spouse to the other. It may seem obvious that a low-deductible policy minimizes your out-of-pocket expenses, but those plans can be more expensive per month. Buying separate health insurance policies can help cut down on costs each month. Careful research should lead you to the right combination after going through numerous quotes.

a) Case A Total Cost with Separate Plans:

The healthier spouse chooses an HSA-qualified PPO bronze plan with a $6,250 deductible and no copayments after meeting the deductible of $6,250. The plan costs $212 per month without an Obamacare subsidy and afterward has nothing more to pay in coinsurance for covered care.

One spouse has more healthcare needs and picks a gold plan with a $2,000 deductible. Without the ACA subsidy, it costs around $317 per month.

On average, this couple will pay about $6,348 in health insurance premiums over the course of a year. The amount they have to pay towards deductibles will depend on how much healthcare they use—but if the healthier spouse only uses preventive care as is typical for her, it would only be possible that the couple will end up having to pay no more than his $2,000 deductible costs for the entire year.

b) Case B Total Cost with Family Plan:

One couple in the article decides to buy an HSA-qualified PPO gold plan from the same company. They will pay $7,596 a year in health insurance premiums–$1,248 more than if they have chosen separate plans according to their individual healthcare needs. In addition, the family deductible is $4,000 before the insurer begins paying its coinsurance, and the family will have to pay 100% of their coinsurance until they reach that deductible.

3. Copayments:

One of you may enroll in a copayment plan if you make frequent doctor visits. While the other decides to opt for high-deductible health insurance paired with a health savings account. If so, you could reap the benefits of both worlds and see lower premiums while saving money on care if needed. If you don’t see the doctor often, a high-deductible plan could serve you better with lower monthly costs. You can set aside savings from your premiums in HSA to cover those rare occasions when doctors’ visits are expected.

4. Prescription Drug Deductibles:

If you and your spouse each take prescription medicines, it may be cheaper for you to sign up with separate medical insurance plans that offer a lower deductible for prescriptions. The total amount of your costs will vary by plan.

5. Combined Deductibles:

If you and your spouse have combined deductibles, you will pre-pay the same deductible amount for medical visits and prescription costs. You may still need to pay a copayment or other out-of-pocket costs after these limits are met.

6. Separate Prescription Deductibles:

A separate drug deductible is often lower, easier to fulfill than medical treatment deductibles.

In 2019, 48% of all gold plans and 54% of platinum plans offered a separate drug deductible.

7. Personal Preferences:

When picking a health plan for your family, you will want to take both of your preferences into account. Some plans do not include providers or hospitals that you may prefer. Buying individual health plans can be more expensive, and it may cost more out-of-pocket because of premiums. That being said, paying a little extra on premiums may be worth the price if this means access to preferred doctors and hospitals for each of you in your family.

Ultimately, you and your spouse need to decide if the separate health insurance or combined coverage will work best for you.