Unless you get a big subsidy under the Affordable Care Act, health insurance for married couples is pretty expensive.
As of 2024, the average monthly health insurance premium for a 40 year-old single male without a subsidy is $560. And the average premium for a couple with both parties the same age was double that, at $1,120 – and that’s for a plan with a deductible over $8000!
Health Insurance for Married Couples – 2024 Guide
So on average, married couples don’t get a price break, although they may come out ahead compared to single individuals due to shared deductible provisions.
Health insurance premiums vary widely by location, as well. For example, before accounting for Affordable Care Act premium tax credits, the average health insurance premium in New Hampshire for a 40-year old individual is $372 per month, while health insurance premiums for a 40-year-old individual in Wyoming are $882 per month, with married couples paying an average of $744 and $1,724, respectively.
Types of Health Insurance Plans for Married Couples
Premiums also vary significantly with your age and the type of insurance plan. HMOs tend to have lower premiums. They also restrict their coverage for non-emergency care to providers in their networks. PPO premiums are slightly higher. They also limit out-of-network care. But unlike HMOs, they allow you to seek care from specialists without first obtaining a referral from your primary care physicians.
Indemnity plans give you much more freedom to choose your own doctor. But premiums are significantly higher.
The equation changes if you’re among the households that qualifies for a subsidy under the Affordable Care Act.
With the passage of the American Rescue Plan and the Inflation Reduction Act, Congress recently expanded the number of people who qualify for a subsidy to help them pay for a health insurance policy over their state’s online marketplace, or through an agent that helps them make that purchase.
Under the current rules, the U.S. The Health Department assesses that roughly 80% of households qualify for at least some subsidy.
But in some cases, the subsidy will be relatively small. And even after the expansion of subsidy availability, millions of Americans are still excluded, and would have to pay full price for an Affordable Care Act-qualified policy.
What is the Cheapest Health Insurance for Married Couples?
The cheapest health insurance for married couples are Bronze-tier, high-deductible plans, if you’re just focusing on monthly out-of-pocket premiums.
However, if you qualify for a subsidy via the Affordable Care Act, you can often buy a much more expansive Silver plan for the same monthly premium. And in some cases, with lower-income couples, the monthly out-of-pocket premium is $0.
According to the Center for Medicare Services, Four out of five enrollees will be able find a plan for $10 or less/month after premium tax credits are applied. And over half of enrollees will be able to find a Silver plan for $10 or less.
How to Lower Your Healthcare Costs
1.) Healthsharing for Married Couples
One great way for many couples to keep their health care costs under control and limit their risk of devastating out-of-pocket costs for major medical events is health sharing.
Healthsharing is a more affordable, lower-cost alternative to traditional health insurance. Instead of buying health insurance through a for-profit corporation, healthshare plan members form an association with like-minded people for the purpose of voluntarily sharing each other’s medical bills.
These associations are administered by tax-exempt, non-profit entities called Health Sharing Ministry Organizations. They set and administer plan rules, collect monthly sharing contributions from their members, and distribute them to those in need.
Healthshare plan members who incur medical bills submit them to the healthsharing ministry organization. If the bills are qualified medical expenses under the plan rules, then the healthsharing organization pays the doctors and hospitals or reimburses the members for expenses over the member’s initial unshared amount (which functions like a deductible).
While each healthsharing plan is different, healthsharing plans routinely save their members 40 to 50 percent compared to the unsubsidized monthly premiums of an ACA-qualified plan purchased via their state Marketplace.
Many healthshare organizations are faith-based, though many have membership criteria that are completely secular. You don’t have to practice any specific faith to benefit from healthsharing, although some plans do cater specifically to their own religious communities.
Healthsharing isn’t a great match for everyone. First, the ACA subsidies don’t apply to healthsharing. However, many people find that healthsharing still saves money even after accounting for subsidies.
Also, unlike traditional health insurance plans, healthsharing organizations may also impose waiting periods before expenses for treating pre-existing conditions become shareable. So healthsharing may not be a great match for you if you have pre-existing conditions.
Note: Unlike health insurance, healthsharing plans don’t have “open enrollment periods.” You can join a healthsharing plan at any time. However, if you’re getting married, or you are going through another life-changing event, you may qualify for a “special enrollment period.” These give you a 60-day window to join a health insurance plan even outside of the general open enrollment period, which runs from November 1st through January 15th for ACA-qualified health insurance.
Compare Pricing on the Best Healthshare Plans Available
2. Join a high deductible health plan and contribute to an HSA
If you have some savings, you can reduce your monthly premiums by joining a high deductible health plan, or HDHP. By joining an HDHP, you may also become eligible to contribute to a health savings account, or HSA.
HSAs allow you to save pre-tax dollars, and pay medical expenses tax free. This allows for significant tax savings. And because you can use your HSA dollars at any provider, and not just the ones in your HMO’s network, you also get more freedom to take charge of your healthcare.
Unspent money in your HSA continues to grow tax-deferred as long as it remains in your HSA. When you turn 65, you can access any unspent funds in your HSA penalty-free. You just pay income taxes on distributions, like you would with any IRA or 401(k).
By taking your premium savings and contributing them to a health savings account, you’ll unlock the potential of thousands of dollars that would stay under your control for your own benefit, rather than send them to an insurance company.
As of 2023, the minimum deductible for an HDHP covering a married couple is $3,000. And married couples can contribute up to $7,750 per year to a health savings account.
3. Dual Health Insurance Coverage for Married Couples
It doesn’t always make sense to have both spouses on the same plan. Sometimes it makes better sense for one spouse to remain on a workplace plan while the remaining spouse and other family members join an ACA-qualified plan.
Congress recently fixed the so-called “family glitch.” Previously, ACA rules excluded households from subsidies if one family member had access to an employer health plan, even if the employer did not extend coverage to families.
Under the new rule, however, this unfair “glitch” has been corrected. You may qualify for a subsidy to help you pay for coverage of family members not included in your employer group health plan.
Another strategy: One spouse with pre-existing conditions may remain on a traditional health insurance plan, which must by law pay for treatment for pre-existing conditions. The other spouse joins a lower-cost healthsharing plan.
Compare Pricing on the Best Insurance Plans Available
Health Insurance for Married Couples FAQs
1) What is the best health insurance for married couples?
There is no single “best” health insurance plan or approach for married couples. The right approach is always fact dependent and highly specific to the individuals involved.
In most cases, the best health plan is the plan that:
- Provides the coverage you need to get quality health care for major and catastrophic medical events without suffering a financial disaster.
- Does so at a monthly premium you can afford so you can keep it in force and not lapse.
Those are the two most important factors in any health plan.
Additionally, you should have a health plan that allows you to see a doctor for routine and preventative care without having to put off needed care due to cost fears.
In many cases, the best health plan for a married couple isn’t insurance at all, but a lower-cost healthsharing plan. This is more likely to be true if:
- You don’t qualify for a large Obamacare subsidy due to your income, and
- You don’t have significant pre-existing conditions that you must have coverage for right away.
The best health plan for you depends on a variety of factors. It’s a good idea to work with an experienced expert who can help you look at all your options, including both insurance and healthsharing, and help you come up with the optimal solution for your specific needs.
2) Can married couples have separate health insurance?
Yes. Married couples can both join the same plan as a couple, or they can have entirely separate plans.
Having separate policies can make good sense if one partner has significant medical needs and expects to consume a lot of health care, while the other partner is very healthy and hardly ever needs to see a doctor.
If this is the case, it can be more cost-effective to have two separate policies: One plan with a very high deductible but low monthly premium for the healthier person, and a lower-deductible, more benefits-rich plan for the partner with more health care needs.
The lower-deductible plan will have a higher premium. But the additional benefits will usually more than make up for the extra cost.
Another strategy that saves even more money is to have the partner with the more significant health care needs on a traditional health insurance plan, while the healthier partner joins a healthshare plan – normally at just a fraction of the cost of an unsubsidized traditional health insurance policy purchased over the ACA exchanges.
3) Do I have to join my spouse’s plan if they have coverage from work?
No. You can elect to have your own plan if you choose. You are not required to join your spouse’s workplace plan.
If your spouse’s employer extends their health benefits to family members, you should compare that plan to others you can purchase on the open market as an individual. If the employer heavily subsidizes the premium, you may get a very good deal.
But this isn’t always the case. Sometimes employers don’t pay family members’ premiums. And in many cases, their plan may have a very limited network of providers available to you.
With an employer plan, you may not be able to see the doctor or visit the clinics or hospitals of your choice.
For this reason, it’s a good idea to carefully compare your spouse’s employer’s plan’s premiums, benefits, and available network of care providers so you can make the best decision for you.
4) Does dual health insurance coverage for married couples make sense?
Yes, dual health coverage can make a great deal of sense for married couples, especially if both partners are similarly healthy.
One benefit that some health insurance policies have for married couples is the shared deductible, or pooled deductible.
With a shared deductible, each person’s medical expenses all count towards a single deductible. The plan won’t pay benefits until the deductible is met. But once it’s met, then the plan pays benefits for both partners on the plan from that point forward, for the rest of the plan year.
Having a shared deductible means that if one partner has a significant medical expense that exceeds the deductible, the other partner won’t have to meet a separate deductible before the plan pays benefits for his or her needs.
5) What is the average health insurance cost for married couples?
According to data from the Kaiser Family Foundation, The average monthly premium for a “Silver” plan covering a 40-year-old married couple was $1,120. That premium was the average for a deductible of more than $8,000.
Younger couples pay less, older couples typically pay more for a similar plan. Also, premiums can vary wildly by zipcode.
Healthsharing plans, in contrast, cost an average of 40% to 50% less than the unsubsidized cost of a comparable major medical plan.
They are a proven strategy for helping control household medical costs, and are an excellent alternative to traditional medical insurance for many families – especially those with no pre-existing conditions and who don’t qualify for a big subsidy under the Affordable Care Act.
6) Do health sharing plans include maternity benefits?
Yes, most health sharing plans do provide significant maternity benefits, though the specifics vary by the individual health sharing plan.
Generally, healthshare plans will share pregnancy-related expenses, delivery-related expenses, and postnatal care expenses for the newborn, as well. You will have a limited number of days to add the newborn to the healthshare plan.
In most cases, you’ll be responsible for an initial unshared amount out-of-pocket, and the healthsharing plan will cover amounts above that, subject to a cap, which varies by plan.
In most cases, healthsharing plan maternity benefits only cover pregnancies that begin before the effective date of the health sharing membership.
Additionally, some faith-based healthsharing plans only include maternity benefits if the mother is married.
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Here are some additional articles related to this article: Is Health Sharing Tax Deductible? – Updated for 2024 | What are the Best Family Health Plans for 2024? [Family Financial Planning Guide] | How Much is Health Insurance for a Family of Four?
And here are some additional pages related to this article: All You Need To Know About Healthshare Plans | How Smart Consumers are Opting Out of Obamacare and Slashing Their Costs by Joining Healthshare Programs Instead!
You can also learn more at healthcare.org
Whitney Kline is a Personal Benefits Manager (PBM) for HSA for America. As a PBM, she helps individuals and small businesses find money-saving alternatives to traditional health insurance – including HSA plans, health sharing programs, DPC memberships, and other innovative solutions.