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My Insurance or My Spouse’s?
If you and your spouse both work, you may both have access to health insurance through your respective employers. Since you have two insurance options, you have several choices when deciding which insurance plan you want. You can opt to keep separate insurance, go with one spouse’s plan, or elect to use both. If you aren’t sure which plan to choose, here are a couple factors you can look at in both plans to determine which is best for each of you.
Which Is the Better Deal?
In looking at the price of your premiums, you’ll probably find it’s cheaper to each keep your own insurance. However, if your doctor isn’t covered by the carrier's network, your co-pays are higher, or prescriptions are a better deal through your spouse’s insurance, it may be a better deal overall to select your spouse’s plan. Other things to consider are the in-network specialists and emergency-care options available in both plans. Before selecting a plan, take a look at the policy limitations and exemptions for each plan. Every company has its own list of clauses that you should read through. You may find that one is better than another.
Customer Service
The provider’s customer service is also important to think about when selecting which plan you want. If you spend 40 minutes on hold every time you call your provider with questions, or if they only provide assistance during regular working hours, you may want to go with an insurance company that has shorter waiting times, 24-hour call service or incredible internet assistance. You may also find that one insurance company is more helpful than the other in answering your questions.
Unfortunately, you can’t change your plan whenever you want. Most times, you have to wait for open enrollment, which is a designated time period that usually happens only once or twice a year when you can accept or decline insurance or change your coverage options. According to the IRS and individual providers’ established rules, you can also change your coverage during special circumstances. Below is a list of special circumstances that your insurance company may accept. Check with them to find out when you can apply for special enrollment.
Special Enrollment Qualifications:
- Marriage
- Birth of a child
- Divorce
- Legal separation
- Change in work hours that affects eligibility
- Your spouse begins or ends a jobs, changing coverage
- Loss of health insurance through your spouse’s plan
- Change of custody
- Qualified Medical Child Support Order (QMCSO)
- Change in qualification for government-administered insurance
- Your spouse’s open enrollment
- Death of a spouse or dependent
- Adoption of a child
Having two options for your health insurance can help you get the best deal. It can also give you more options for doctors, emergency care and customer-service styles. One of the best parts about having two insurance choices is that regardless of which provider you select, you can change your mind – and your benefits – in six months or a year, depending on your open enrollment schedule.