Getting married? What to do about health coverage

Five tips to get you started…

Nothing says togetherness like a family deductible. While it’s not the most romantic notion, your marriage nuptials are considered a qualifying life event—and that means you and your new spouse can get or change health coverage as soon as you’re married. This eligibility applies to any kids you might already have, too.

So how best to plan for the big life changing leap into the health coverage pool after getting married? Start with these five considerations:

1. Do you both have coverage through your employers?

  • First, check whether your employer plans cover dependents.
  • If so, investigate how much your coverage is costing each of you (including monthly premiums, co-payments, co-insurance, and deductibles) and determine if you’d save money if you were both covered under one of your plans.
  • If you want to keep seeing certain doctors, check each plan’s network.
  • Check if either employer has a “spousal surcharge,” which is a fee added to your monthly premium if you elect coverage for your spouse when your spouse is eligible for coverage from his or her own employer.

2. Do you have employer coverage but your spouse doesn’t?

  • If your employer covers dependents, you can enroll your spouse in your employer plan. (Spousal surcharge doesn’t apply if your spouse isn’t eligible for coverage under his or her employer.)
  • You can also consider individual and family plans for your spouse or even for your whole family. These plans are offered direct from organizations like Kaiser Permanente or through the state’s exchange marketplace, Washington Healthplanfinder. You might find a plan better suited to you both or one that costs less than your employer coverage.

3. Act quickly—once you’re back from your honeymoon, of course

  • You have 60 days from the date of your marriage to obtain coverage.
  • If you enroll through your employer, the deadline might vary so make sure you check.
  • If you miss the window of opportunity that your qualifying life event provides, you’ll have to wait until the open enrollment period, typically in the fall, to seek coverage.

4. Keep enrollment cutoff dates in mind

If you want coverage sooner than later, plan to enroll as soon as possible after you’re married.

  • If you enroll through Washington Healthplanfinder, the deadline is the 23rd of the
    month for coverage on the first day of the following month.
  • If you enroll directly from Kaiser Permanente, you’ll have coverage on the first of the month if you make your plan selection by the last day of the previous month.
  • If you wait until the end of your 60-day qualifying-event window to enroll in a plan, you’ll have coverage…just not as quickly as you might like or need.

5. About that family deductible—is it aggregate or embedded?

  • Some plans feature aggregate deductibles, which means the entire family deductible must be met before any one family member will experience the plan’s full coverage.
  • Other plans, like the ones we offer, offer embedded deductibles. Once one person meets his or her individual deductible (usually about half the amount of the family deductible), the plan’s full coverage kicks in for that person without the entire family deductible needing to be met. Other family members continue to pay toward the family deductible amount.

This kind of pre-wedding planning certainly isn’t as much fun as making your reception playlist or tasting cakes, but checking it off of your list means you can rest easy and enjoy your party that much more. Best wishes for a healthy and happy life together!

Getting married? Compare individual and family plans and rates. Get a quote for your health care coverage. 

Coverage provided by Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.