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Healthcare for Married Couples

Daniel Walker
Licensed Insurance Agent for 15 Years

UPDATED: Mar 19, 2020

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The lowdown...
  • Married couples can purchase health insurance together
  • This is true even if both spouses can afford and are eligible for insurance independently
  • Married couples who file jointly may be eligible for financial assistance through the Marketplace

You can get health insurance in a number of ways, and it’s a good idea to compare your options before finalizing your insurance for the year. If you’re a married couple, you can purchase health insurance together.

You can do so through the following ways:

  • the Marketplace
  • an employer
  • Medicaid
  • on your own

A spouse can also get insurance on his or her own. There may be certain financial benefits associated with getting insurance together.

The Health Insurance Mandate


Every American is supposed to obtain health insurance under the Affordable Care Act. When people can afford health insurance but do not buy it, financial penalties are incurred.

The penalty is called the individual shared responsibility payment, and it’s due whenever you pay taxes. If you’re owed a refund, the payment will be taken out of your refund check. Those who are not owed a refund are asked to make their payment when they file their taxes.

The penalty is either:

  • 2.5 percent of your household income
  • $695 per adult in your household who is not insured

You’ll be asked to pay the higher of these two amounts. For a married couple, the household income includes both spouse’s salaries.

Exemptions to the Mandate

There are certain situations in which you’re not asked to pay the penalty for not having insurance, whether you’re a married couple or not. Exemptions are given to people who:

  • Went without health insurance for less than three consecutive months
  • Have been living abroad
  • Someone in your household has died during the year
  • You don’t make enough money to file taxes

There are other circumstances that can qualify you for an exemption. You’ll apply for an exemption by using Form 8965 when you file your taxes with the IRS.

How to Obtain Health Insurance


You may be able to obtain health insurance through your employer, especially if you are a full-time worker.

Most businesses with over 50 employees are required to provide insurance benefits to their employees. If you do get these benefits, you have the opportunity to sign up for a plan when you first start working. You’ll also be able to include your spouse in your plan.

If you don’t have health insurance through work, or if your employer-sponsored plan is not ideal for you, you have a few options.


Medicaid is a government program available to certain low-income individuals. If a person qualifies for Medicaid, then his or her spouse can also join the plan. The program is administered by states, and each state has set its own requirements for eligibility.

Many states grant eligibility to families with household incomes up to 133 percent of the federal poverty level.

The Marketplace

You and your spouse can also seek health care coverage through the Marketplace. The Marketplace was set up in accordance with the Affordable Care Act, and it allows you to join a pool of other individuals who also want to find insurance.

There are four types of plans offered through the Marketplace:

  • Bronze
  • Silver
  • Gold
  • Platinum

The Bronze plan comes with the lowest monthly premium but the highest out-of-pocket costs. On the other end of the spectrum, the Platinum plan has the highest monthly premium and the lowest out-of-pocket costs.


If you’re 65 years of age or older, you may be eligible for Medicare. You can receive Medicare benefits if you or your spouse paid Medicare taxes for at least 10 years.

Private Insurance

You can also compare your options by contacting insurance companies and gathering details about various plans. Some plans may have lower monthly premiums and higher out-of-pocket costs, and vice versa.

Making Changes to a Plan


When you get married, you have the opportunity to update your health insurance so you can make sure that your spouse is covered by your plan. You can update your plan to reflect a change in your household during a special enrollment period.

Typically, that special enrollment period ends within 60 days of the day that you officially got married.

Each plan may have a different amount of time in which you can apply to include your spouse in your coverage, so it’s important to check with your insurance company regarding the details.

If you forget to add your spouse to your insurance plan, you will likely have to wait for the open enrollment period. This period is usually at the end of the year.

Adding a spouse (or other dependents) to your plan can affect your premiums. Insurers are allowed to charge more for plans that include spouses in comparison with plans only for individuals.

For this reason, you may want to compare the available plans before you decide on one to purchase.

Financial Implications


Based on income, some families may be able to receive subsidies in the form of premium tax credits and cost-sharing reductions when purchasing health insurance through the Marketplace.

Premium tax credits can be applied to your monthly premium, in effect lowering your monthly payment. They are available to many households making up to 400 percent of the federal poverty level.

Cost sharing reductions can lower your out-of-pocket payments and significantly reduce your deductible. These reductions are only offered to people who sign up for a Silver plan through the Marketplace.

Only married couples who file taxes jointly can apply for these subsidies. If you are married and file separately, you can purchase a Marketplace plan together but cannot receive financial assistance.

The health insurance system has been set up so that married couples can purchase health insurance plans together.

In general, people can obtain insurance together if they have job-based insurance, insurance through a government program, or insurance purchased directly from a company.

You can shop around to compare your options, especially if adding a spouse to your plan may affect your premiums and out-of-pocket costs. You may have to wait for an open enrollment period to join a new plan.

If you’d like to add your spouse to your existing plan, you can do so the day you get married and shortly after.

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