Getting Married to Get on a Spouse’s Health Insurance: What You Need to Know

If you’re engaged, you’ve probably thought about getting married to combine your finances and lives. But what if one of you has a pre-existing medical condition? Can getting married help you get better health insurance coverage?

What is the Affordable Care Act (ACA)?

The Affordable Care Act (ACA) is a health care reform law that was passed in 2010. The ACA has made it easier for people with pre-existing conditions to get health insurance. Before the ACA, insurance companies could deny coverage to people with pre-existing conditions or charge them higher premiums.

The ACA prohibits insurers from:

Denying coverage for any pre-existing condition
Charging higher premiums for individuals with pre-existing conditions
Coverage may not be subject to a waiting period beyond typical coverage effective dates (open enrollment being 1st of the year and QLE being the first of the month following changes)

Can Getting Married Help You Get Better Health Insurance Coverage?

If your fiancé has a pre-existing condition, getting married may help them get better health insurance coverage. Your employer-based health insurance plan may offer better coverage than your fiancé’s Marketplace plan.

However, there are a few things to keep in mind before you get married for health insurance purposes:

You need to wait until you’re legally married. Getting married just to get on your fiancé’s health insurance plan is considered fraud. You need to wait until you’re legally married to add your spouse to your plan.
Your spouse may lose their Marketplace subsidies. If your fiancé is currently receiving Marketplace subsidies, they may lose them if they get married. This is because your income will be combined when you file your taxes, and your income may be too high to qualify for subsidies.
You may have to pay a fee to add your spouse to your plan. Most employer-based health insurance plans charge a fee to add a spouse to the plan. This fee can vary depending on the plan.
You need to consider the tax consequences. Getting married can have tax consequences. You need to talk to a tax advisor to make sure you understand the tax implications of getting married.

Other Options to Consider

If you’re not sure if getting married is the right option for you, there are other ways to get your fiancé better health insurance coverage.

Your fiancé can explore other Marketplace plans. There are a variety of Marketplace plans available, and your fiancé may be able to find a plan that offers better coverage.
Your fiancé can apply for Medicaid or CHIP. Medicaid and CHIP are government health insurance programs that provide coverage to low-income individuals.

Conclusion

Getting married can be a great way to combine your finances and lives. However, if you’re considering getting married to get your fiancé better health insurance coverage, there are a few things you need to keep in mind. You need to wait until you’re legally married, your spouse may lose their Marketplace subsidies, you may have to pay a fee to add your spouse to your plan, and you need to consider the tax consequences. If you’re not sure if getting married is the right option for you, there are other ways to get your fiancé better health insurance coverage, like exploring other Marketplace plans or applying for Medicaid or CHIP.