ACA Marriage and Insurance Options

Marriage is an exciting life event. It’s also a time when your insurance needs may change. If you and your spouse both had ACA plans before getting married, you’ll need to decide how to proceed most cost-effectively.

Under the Affordable Care Act (ACA), you need to let the Health Insurance Marketplace know when you have certain life changes within 60 days, such as getting married. This is because your new status and plans may change the amount of financial help you get through the Marketplace. Getting married may affect your eligibility for premium tax credits and cost-sharing reductions.

If you’re married and both of you have health insurance through your employers, you may be able to drop your Marketplace plans both off-Marketplace and keep your employer-sponsored insurance. Do some research on both plans and what each of them covers in terms of benefits. It is also wise to find out how much the premiums will be for both and calculate whether the Marketplace plan will be more cost-effective for your family.

If only one of you has an employer plan and the other is on an individual Marketplace plan, you may be able to drop your Marketplace plan and add your spouse to your employer’s plan. Be sure to be aware of costs and coverage with both plans before making a decision about this, and most employer-sponsored health plans have an open enrollment period of 30 days, you may want to apply for this as soon as possible if you think this is the best plan of action for you and your spouse.

Another option is to keep both of your Marketplace plans and enroll in a family plan. This may be helpful if you have an employer plan that doesn’t offer family coverage or if your spouse’s Marketplace plan offers better coverage than your employer plan.

No matter which option you choose, it’s crucial to remember to let the Marketplace know about your marriage within 60 days so they can update your records. You can do this by logging into your HealthCare.gov account or by calling the Marketplace call center at 1-800-318-2596. If you don’t report your marriage, you may have to pay back any premium tax credits or cost-sharing reductions you received.

If you are unsure about what to do in this case, as insurance plans can get complicated, it is a good idea to contact a licensed health insurance agent to help guide you through the process.