Choosing a Health Plan as a Newlywed

I just hit a major life milestone—I got married! I planned my wedding, walked down the aisle and shared memorable moments with those I cherish most. But now it’s time to think about the legal aspects of marriage, like joining health insurance with my spouse! If you’re looking for tips on joining or transitioning health plans as a young adult, this is your guide.

Let’s be real, hearing the word insurance can be a little daunting. Especially when it comes to health insurance. If you’re like me and under the age of 26, you might still be piggybacking off your parent’s insurance plan—and that’s okay. Up until getting hitched, health insurance wasn’t anywhere on my radar. One, because I didn’t have to worry about coverage since I was under my parents’ plan and two, because…what legal stuff is fun, anyway?

I’m in a unique position working as a Marketing Coordinator at MDsave, which means I have a great insider view on all things healthcare. Not only do I get to change healthcare for the better, but I get to do what I love— helping patients every day. And now I can help you.

I’m here to help you navigate the major life decision that is choosing health insurance for your first time. So, if you just tied the knot or if you’re planning to get off your parents’ plan soon, here are some things you need to know about health coverage:

Young Adult Coverage

Not over the age of 26 quite yet? Under the current law, you can join or remain under your parents’ plan even if:

• You’ve gotten married

• You’re attending school

• You’re eligible to enroll in your employer’s plan

• You’re no longer living with or dependent on your parents

Once your 26th birthday comes around, coverage under your parent’s plan is usually automatically terminated. But check with the employer or plan since some states and plans have different rules.

Making Sure You’re Covered

If you experience major life events such as getting married, turning 26 or even losing health insurance, you may qualify for a special enrollment period to enroll in the marketplace.

Most people enroll in health insurance every year during open enrollment, which typically starts in November and ends mid-December. Once I tied the knot, which is a major life event, I was eligible to make changes to my plan out of the open enrollment period. This had to be done within 60 days.

Know Before You Pick

1 in 4 people have avoided care because they were unsure of what their health insurance covered, and 13.2% of people are unsure if they even have insurance. Yes, choosing a health plan can sometimes be confusing and there are many things that you need to consider. But that doesn’t mean you should put your health at risk.

Some questions to ask yourself when choosing a plan is: 

• Does it include a

   

  ? 

• What will it cost per month? 

• Are there additional perks or benefits?

A perk that I now have with my new plan is the option to meet with a doctor virtually. I found this to be super convenient, especially with how busy life can get sometimes. Simply researching and knowing before you pick your plan can be beneficial. 

PPO vs. HDHP

Of course, the most important consideration when choosing your health insurance is to make sure that the healthcare services you need are covered by the plan. But first, you need to know what the differences are. There are many different plans out there (HMOs, PPOs, EPOs, HDHPs, etc.), so you’ll want to look into each one. 

My spouse and I narrowed it to two plans: a preferred provider organization (PPO) and a high-deductible health plan (HDHP). What’s the difference between these two? 

• A PPO plan offers a high monthly premium (what you pay each month), copay benefits (fixed amount you pay at your appointment) and depending on the plan, a low deductible. You have access to a large network of participating providers and the flexibility to choose a doctor or hospital of your choice. 

• An HDHP offers a low monthly premium but higher immediate out-of-pocket costs. You have to pay your healthcare costs and meet your deductible before the insurance company starts to pay its share. An HDHP can be paired with a health savings account (HSA).

My spouse and I researched both of our employer plans and ultimately decided to choose one that made sense financially, and of course, that provided the best coverage for both of us. Every plan is different, so you should do your own research to see what fits you (and your spouse) best.

Take Action

Now that you know—go out and do your research and choose the best plan possible. One thing my experience choosing health insurance taught me is that my health always comes first, so it’s worth the time to research and understand my coverage.

If you’re one of the 8.5% of people who don’t have insurance or one of 43.2% of people with a high deductible plan, no worries—there are options! My colleagues and I at MDsave are here to help. If you ever come across a situation where you need to pay out-of-pocket for care, check out MDsave.com to see prices for available providers near you. Remember, your health should always come first. 

Sources:

https://www.healthcare.gov/young-adults/children-under-26/

https://www.healthcare.gov/coverage-outside-open-enrollment/#part=2

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Coverage-for-Young-Adults

https://www.prnewswire.com/news-releases/health-insurance-confusion-is-growing-in-america-policygenius-annual-survey-finds-300945209.html

https://www.census.gov/content/dam/Census/library/publications/2019/demo/p60-267.pdf

https://www.beckershospitalreview.com/payer-issues/cdc-finds-43-2-of-americans-have-high-deductible-health-plans-4-additional-stats.html

https://smartasset.com/checking-account/hsa-vs-ppo