Why Couples Should Consider Separate Health Care Plans
From 2010 to 2016, the number of medically uninsured people in the United States decreased from over 46 million people to about 27 million. This is primarily because of the ease of access which people could insure themselves via the Affordable Care Act. Still, the number of uninsured Americans increased to 28 million by 2018. This reality is testament to the intricacies and misconceptions people may have about health insurance acquisition. People acquire health insurance through different ways for many different reasons. Its why it may be most prudent for couples to acquire separate health care plans.
The Affordable Care Act of 2010 was designed to aid Americans living just above and under the poverty line get health insurance coverage through state coverage exchange programs.
Private health care insurance coverage is prohibitively expensive for many Americans to get.
While many Americans qualify for public or state-sponsored health insurance, usually at low-cost, misconceptions prevent them from getting.
So, how do most Americans get their health insurance coverage needs met? Well, it’s mostly directly or indirectly through work-sponsored health insurance plans.
Ultimately, your ability to get substantial health insurance could hinge on the quality of a spouse’s or parent’s work contract package.
If that is a good or bad thing is a matter of perspective.
Or, the quality of your own, or your spouse’s, work-sponsored health insurance coverage.
Employer-Sponsored Health Care Insurance Programs
The fact of the matter is that most Americans get health insurance coverage through work or indirectly through the coverage of a spouse’s work plan.
That can be a precarious state of affairs to constantly live under.
About 60 million American women get their health insurance benefits directly from their spouse’s employer sponsored health care plan.
Think about that statistic. Almost 60 million American women exclusively get their health care indirectly through the health insurance plan coverage extended through their spouse’s job.
This situation is more common than you might think.
Almost 49% of Americans get their health insurance coverage needs supplied from their spouse’s work-supplied health insurance.
Almost 156 million Americans get their health insurance coverage directly or indirectly from employer-sponsored plans.
In fact, work-sponsored health insurance plans, also known as group health insurance, is the primary way that most people get the health insurance needs of their spouses and children supplied.
These employer-sponsored health insurance plans are no doubt beneficial. Such plans are the primary way most people get health insurance.
Still, such plans feature bureaucratic gaps and arbitrary exclusion conditions in coverage benefits.
This means that people who depend upon their spouse’s job for health insurance coverage could lose it at a moment’s notice.
The Limitations of Employer Sponsored Health Care
Each employer and business acquire their own independent health insurance plans to incorporate into their employee contract packages.
These plans are upgraded and changed annually or semiannually to cut costs and trim business expenditures.
Employer-sponsored health insurance plans can be altered, changed, or downsized beyond the control of the employee.
And, at the coverage expense of the employee’s family.
So, premiums, or the amount of money withdrawn from a paycheck to pay for such plans, can increase or decrease annually beyond the control of an employee.
The amount for a copay could fluctuate annually.
Additionally, the number of family members that may be eligible for coverage on an employer-sponsored health insurance plan can arbitrarily fluctuate at will as well.
In other words, a sudden instance of unemployment or a business renegotiating their employee health insurance coverage options can suddenly strip spouses, or their children, of health care coverage.
That is one of a few reasons why couples should acquire separate health insurance plans.
Coverage could evaporate at a moment’s notice due to unemployment or employer bureaucracy.
The Benefits of Separate Health Care Plans
The main benefit of spouses maintaining separate health care plans is the maximization benefits of coverage.
This is a smart thing to do if feasibly possible. (Which it isn’t always possible due to the realities of life.)
A spouse losing or changing a job can have catastrophic impacts on a family. One or both spouses as well as children can lose health coverage in the aftermath of a situation.
Also, a couple with separate health insurance plans can maximize their savings when it comes to health care coverage.
Over 11% of employer-sponsored health insurance plans won’t allow a spouse to enroll if that spouse has their own health insurance coverage.
Further, over 33% of companies mandate a spousal enrollment fee on an employee’s plan, especially if the spouse has their own coverage. That could amount to over $1,200 annually.
While in some cases paying for a spousal enrollment fee may be cheaper than acquiring an individual private plan, there are no real cost savings to be had. Especially for the average family of four.
The average family of four spends over $22,000 annually on health care premiums via employer-sponsored health care. This is true even though employers usually pay for half or most of the premium, although such standards vary by employer.
Because of such grim realities, almost 30% of American couples are enrolled in different health care plans in the same family.
This is a situation where it may not pay to have all of your eggs in one basket.
Or, having every member of one family enrolled in the same plan.
However, as stated before, most people don’t have a lot of options when it comes to health care.
Or rather, they convince themselves that they don’t.
Why do so Many Americans go Without Health Care?
In a recent survey by the Kaiser Family Foundation, over 45% of uninsured Americans said that they don’t have health insurance because of its high cost.
About one-in-five uninsured adults go without medical care because of high costs.
Most of the people who go without health insurance come from working class families with only one adult working full-time.
Unemployed and under-insured people believe that they just can’t afford access to health care or are ineligible, which isn’t always necessarily the case.
If you, or someone you know, is uninsured, you should go to Healthcare.gov to check your eligibility for publicly funded health insurance.
You could find health insurance coverage that meets your needs at extremely low cost.
Also, if you apply in the right manner, individuals in the same family could qualify for different health care plans.
The point is that there is no benefit in making assumptions when it comes to health care.
Also, the longer that you go without health insurance, the greater your probability of being catastrophically impacted financially by a potential medical emergency.
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Allen Francis is a full-time writer, prolific comic book investor and author of The Casual’s Guide: Why You Should Get Into Comic Book Investing. Allen holds a BA degree from Marymount Manhattan College. Before becoming a writer Allen was an academic advisor, librarian, and college adjunct for many years. Allen is an advocate of best personal financial practices including saving and investing in your own small business.
