Do Health Insurance Companies Check Marriage Status for Eligibility

Health insurance companies do check marriage status for eligibility, but it's not always a straightforward process. This can be confusing, especially for couples who are newly married or in a domestic partnership.

In the US, the Affordable Care Act (ACA) requires health insurance companies to offer coverage to all applicants, regardless of their marital status. However, some states have their own laws and regulations regarding spousal coverage.

Some health insurance companies may ask for proof of marriage or domestic partnership when applying for a family plan, while others may not.

If one spouse had health coverage for at least one day in the 60 days before the marriage, the other spouse may join their plan. This is a great option for couples who get married quickly after meeting.

You'll need to provide an official document that proves the date the marriage took place to your health plan provider. This is a straightforward process, but it's essential to get it right.

The health plan provider will accept a marriage certificate, license, public record, religious document, or an affidavit signed and dated by an officiant or official witness as proof of marriage. These documents can be mailed or sent electronically.

It's a good idea to send the documents soon after your marriage because the 60-day Special Enrollment Period begins on the day of the marriage. Acting quickly allows for any issues with documents or mailing to be resolved without cutting too close to the deadline.

You and your spouse can decide whether to keep your existing plans or join one plan. Factors to consider include the cost of the plans, coverage, and participation with existing health care providers.

Marriage certificates and licenses are accepted as proof of marriage for health coverage. They can be mailed or sent electronically to your health plan provider.

A copy of one of the accepted documents can be sent to your health plan provider. If you don't have one of these documents, reach out to your health plan company.

The documents you send should be signed and dated by an officiant or official witness. This includes affidavits, public records, and religious documents.

Here are the accepted documents for proof of marriage:

If one spouse had health coverage for at least one day in the 60 days before the marriage, the other spouse may join their plan.

In some cases, both spouses had health coverage before the marriage, and they need to decide whether to keep their existing plans or join one plan. The cost of the plans, coverage, and participation with existing health care providers are key factors to consider.

You'll need to provide an official document to your health plan provider that proves the date the marriage took place.

The document can be a marriage certificate or license, public records, religious documents, or an affidavit signed and dated by an officiant or official witness.

Here are some accepted documents for proof of marriage:

It's a good idea to send these documents soon after your marriage, as the 60-day Special Enrollment Period begins on the day of the marriage.

A common law marriage can affect health insurance eligibility, allowing the spouse to enroll in the employer's insurance plan.

Employers must recognize a common law marriage and include the spouse in their insurance contractual definition of "spouse."

The employer must allow the enrollment of a spouse from a common law marriage the same as a spouse from a traditional marriage.

Under a common law marriage, children have a presumption of legitimacy and are considered dependents eligible for health coverage.

Employers should check state laws on common law marriage recognition and specific provisions and requirements.

A signed affidavit from an employee may be required by employers or insurers to recognize the common law marriage.

Proof of the common law marriage can be shown with evidence such as joint tax returns, checking accounts, mortgage or lease, or other requirements specified under state law.

The Full Faith and Credit clause of the U.S. Constitution requires a state to accept a common law marriage established in a state that recognizes it.

Many employers offer health insurance as part of their benefits package, and getting married can be a game-changer for your coverage options.

You can apply for coverage for your spouse through your employer's health insurance package, which can help you get a discount on your policy, sometimes as much as a five percent discount.

LGBTQ+ married couples are entitled to the same benefits as straight married couples in states where same-sex marriage has been legalized.

Employers are not allowed to discriminate against non-straight couples, and if they allow spouses to join their employees' health insurance packages, it doesn't matter what gender the spouse is.

This means one person in the marriage might not have benefits through their employer, they might not have benefits because they work freelance, or they might have lost benefits due to being laid off during the pandemic.