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Can My Health Insurance Cover My Spouse?

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For more information about the Affordable Care Act, visit CBSSanFrancisco.com/ACA.

The availability of coverage for your spouse depends on your specific health plan. Some policies allow you to add a spouse to existing coverage at certain times like when there is a life qualifying event. Others require you to purchase a new policy jointly. For example, if you are insured through your employer, the availability to extend coverage to your spouse will depend on the type of plan your employer provides. However, if you are uninsured and shopping for a plan, you will be able to purchase one that covers both you and your spouse.

Job-based health insurance

The Affordable Care Act (ACA) assesses a penalty on large businesses — those with 50 or more full-time employees — that fail to offer health insurance benefits to its employees. Most large employers do offer coverage, but they are not, under the law, penalized if they do not extend coverage to an employee’s spouse or children. A plan that covers an individual as well as that individual’s spouse and/or children is known as a family plan.

If your employer opts to offer a family plan, you should be able to add a spouse, though possibly only at certain times — for instance, right after getting married, if your spouse loses a job that provided coverage or during a specific enrollment period each year.

If your employer does not opt to offer a family plan, your spouse may enroll in a health plan through the health insurance exchange. Depending on your spouse’s income, he or she may be eligible for tax credits and cost-sharing reductions to defray the cost of premiums and health care.

If your employer does opt to offer coverage for your spouse, but your required contributions to premiums are unaffordable (more than eight percent of your household income), your spouse will be exempt from being penalized for not having insurance if he or she opts not to purchase it. That penalty under the ACA is known as the shared responsibility payment. There are many exceptions to the shared responsibly payment — this being one of them. 

Enrolling in a plan through the health insurance exchange

If you need insurance, you and your spouse may purchase coverage under one plan in the health insurance marketplace. When registering at Healthcare.gov or your state’s exchange website, you will be prompted to enter the names of everyone seeking coverage in your household.

If you already have a marketplace plan for yourself, you may change it to include your spouse if you experienced a qualifying life event such as marriage or job loss. If you do not have a qualifying life event, you must wait until the next open enrollment period to add your spouse. Open enrollment for 2014 ends March 31. The open enrollment period for 2015 is scheduled to open Saturday, November 15, 2014.

Gillian Burdett is a freelance writer covering all things home and living. Her work can be found on Examiner.com.

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