Newlyweds

You’ve pledged your love, said “I do,” and, as is often tradition, placed the top tier of your wedding cake in the freezer, to thaw and share on your first anniversary.

As you begin a happy new life together, you’ll have some decisions to make — not just about which gifts to keep but also about your health coverage. If you’re not sure what to do next, here are five tips to help get you started.

Getting married is considered a qualifying event, which means you’re allowed to make changes to your health coverage outside of open enrollment. You’ll want to report your change in marital status to your insurer, or your insurance exchange, but you don’t need to switch policies if:

  • You and your new spouse each have your own employer-based coverage and you’re satisfied with your plans.
  • You haven’t reached your 26th birthday and you’re covered under a parent’s plan. (Yes, you can stay on their plan even if you’re married.)
  • You have a marketplace plan that you like and can still afford (because getting married can change your tax credit eligibility).
  • Most employer-based plans give you a window of 30 days from the date of your marriage to make changes to your coverage. If you both have employer plans that offer spousal coverage and one plan is better than the other, one of you can switch. Some things to consider when comparing plans:

  • Price. Look at premiums, copays, coinsurance, and deductibles to figure out which plan is a better deal, or more affordable.
  • Coverage. Compare benefits to see what’s covered under each plan. This is especially important if you have ongoing health issues — you don’t want to get caught by surprise later.
  • Network. Check both provider networks to see which physicians, hospitals, and medical facilities participate, and whether you’ll have to change doctors if you switch plans. This may or may not be a deal breaker, but it’s something to think about.
  • Beginning in 2015, most insurers offering health coverage to spouses in traditional marriages must also offer coverage to same-sex spouses. Many insurers have made this change already. It doesn’t matter what state you live in, as long as you were married in a jurisdiction where same-sex marriage is recognized.

    Just remember that if you or your spouse wants to make changes, you'll need to do it within the time allowed or wait until the next open enrollment.

    If you already bought coverage through one of the Affordable Care Act (ACA) exchanges and you want to keep it, you can. If you’re currently receiving a tax subsidy, however, getting married (if there are now two salaries in your household) may bump you into a higher income bracket and you may no longer be eligible for tax credits. For a family of two, in 2015, a household income of more than $62,920 means you won't qualify.

    Also keep in mind that if your spouse’s employer offers coverage to you and it meets the ACA's minimum requirements, you won’t be eligible for tax credits.

    If you’re getting married, you can purchase a new marketplace plan (or change your existing marketplace coverage) as long as you do it within 60 days of tying the knot.

    Not only can you shop the marketplace (including on GetInsured), but you may be eligible for a tax credit if your spouse's coverage is considered "unaffordable." Under ACA law, unaffordable means that your spouse's premium exceeds 9.5 percent of your total household income.

    Unfortunately, this means that the law created a bit of a glitch for married couples, because affordability is based on the cost of insurance for the family member who has employer-sponsored coverage, not the cost of insurance for the entire family. This “family glitch” could mean that you won’t qualify for a subsidy even though the cost for insuring your entire family is more than 9.5 percent of your household income.

    Sometimes a new marriage comes with a ready-made family — i.e., a couple of kids. If you’re a biological parent or the parent of a legally adopted child and getting married (or remarried), and your existing plan or a new plan you’re considering allows for dependent coverage, then your child (or children) can be covered up until age 26.

    Some plans may include dependent coverage for stepchildren, so if you’re a stepparent looking into coverage for a stepson or stepdaughter, you’ll want to check your policy to see if it’s available. But first check your spouse’s divorce decree to see who is responsible for providing coverage.