Switching to your spouse's health insurance or a partner's health plan may save you money. If you and your spouse or partner are both eligible for employee health benefits, check out each company's health insurance options during open enrollment to see which may cost you less. Employers differ considerably in the amount of premium contributions and you may be able to save money by switching to your spouse's family coverage.
At your company's open enrollment time, look at the various plan options your employer offers. You may be able to save money by choosing a different plan, such as an HMO or PPO that requires you to choose a primary care doctor to coordinate your care. In many areas of the country, the local physicians may be in all or most of the health plan networks and you may not have to be concerned about changing doctors.
Take Advantage of Open Enrollment
Many large companies offer a variety of health plans. During your company's open enrollment period, you may be able to change your coverage from one health plan to a different plan regardless of your medical condition. You may be able to make other choices, such as increasing or decreasing the amount of your annual deductible. You also can start health coverage if you don't have any or drop coverage if your company allows.
Most companies hold their open enrollment periods (usually lasting one month) in the fall of each year to allow for changes in health benefits on January 1 of the coming year. Some companies have their open enrollment periods at other times and you can expect to receive sufficient notice in advance.
Once your company's open enrollment period ends and you have made your choices for the coming year, your health coverage is locked in until the next yearly enrollment period. Unless you have some type of qualifying event, you will not be able to modify your health coverage for a full year.
A qualifying event allows you to change your job-based health insurance coverage anytime during the year. What qualifies as an "event" is determined by the Internal Revenue Service (IRS) and includes:
- Birth or adoption of a child
- Divorce or legal separation
- Death of your spouse or one of your dependents
Additionally, if you have a managed care plan (such as a PPO or HMO) and use a provider network, you may be able to change health plans if you move to a different community.
Deciding Which Job-Based Plan to Use May Save You Money
Although it may take you some time, run the numbers to see if it makes sense for all members of your family to stay on the same health plan. You may be able to save money by having separate health coverage for some members of the family. For example:
Don and Barbara
Don S., age 46, and his wife Barbara S., age 44, both have the option for health insurance through their employers. They have family coverage through Don, which includes coverage for their two children, ages 10 and 14. Don is overweight and has type 2 diabetes, high cholesterol, and high blood pressure; he uses a lot of health care services. Barbara and the children are in excellent health and have only needed routine checkups in the past several years.
Because of Don's health problems, they have a low deductable family health plan that has very high premiums. The family may be able to save money by having Don switch to a low deductible individual plan through his employer and have Barbara choose a higher deductible family plan for herself and the children through her employer.
Maria and Jorge
Maria G., age 32, and her husband Jorge G., age 33, both work fulltime and have individual health insurance from each of their employers. Both companies have an open enrollment period from mid October through mid November.
In September, Maria gave birth to a baby boy, a qualifying event that allowed them to add Jorge, Jr. to one of their health insurance plans. However, adding a dependent to either plan changes the insurance coverage from individual coverage to family coverage, which significantly increases the monthly premiums.
Faced with an increase of more than $250 each month from either employer, the couple looked at their options. One option is to wait until open enrollment and put all members in the family in one health plan from one employer - they will save money by dropping the individual plan from the other employer.
Another option is to purchase a private insurance policy for the baby. The couple, who live in the Phoenix area, was able to go online and find more than a dozen plans from well-known insurance companies that would provide adequate coverage for Jorge, Jr. for less money than the increased premium at work.