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How married couples maximize health insurance
benefits
By
• Bankrate.com
Once you've gone and got hitched, life is all about
mixing it up. You merge your bank accounts. You file a joint tax
return. Heck, you even share a sock drawer. Why not think about
hitching up your health benefits as well?
If one of you has a job that offers health benefits
and the other doesn't, the answer is obvious: The spouse with coverage
should add the other to the plan as a dependent. Considering that
44 million Americans go without health care coverage, no one who
has the option should turn it down. But in many marriages today,
both spouses work and sport their own insurance plans. In these
cases, deciding whose health benefits to go with becomes a matter
of comparing the plans from head to toe.
Cost
From a dollars-and-cents perspective, it's almost always cheaper
for a couple in which both people work to keep their individual
health plans. Adding a spouse to a plan typically costs the employer
more money, which translates to bigger premiums for the employee.
Employers save money when you elect to decline health coverage,
so see if they'll give you cash back if you show that you are properly
covered under someone else's plan.
Plan design
Not all plans have the same benefits or the same level of coverage.
Say your spouse has a health package with a great dental plan while
yours has 20/20 vision coverage. If you've got eyes like a hawk
and mouthful of teeth like Austin Powers, switching to your spouse's
plan may actually cost you less in the long run, particularly if
you make frequent visits to the dentist.
It's worth comparing the cost of out-of-pocket expenses
such as co-payments for office visits and prescription drugs. Many
plans limit the drugs you have access to or raise the co-payment
for certain types of prescriptions. Mental-health care is another
place they can get you: Some plans cap the number of visits to psychiatrists
and social workers or offer only a predetermined amount of coverage.
Look closely at your plans and determine which one does the most
for you both.
You can get individual rating on insurers online through
the consumer site Insurance
News Network, which provides data from Standard
& Poor's.
Doctors
The most important issue for many people looking at insurers is
whether their favorite doctors are in their group plans. If both
you and your spouse are covered by the same big network, this isn't
usually an issue -- the network of doctors is going to be the same
no matter where you work. But if you're jumping to a different health
care provider, there's a good chance the doctors won't be the same.
Consider your primary care provider and any specialists you or your
spouse use. Is that proctologist with the great sense of humor in
your spouse's plan? The gentle gynecologist? Staying with those
who make you feel comfortable is important.
Along the same lines, be sure to take a look at your
out-of-network options. Many managed-care plans allow you to move
outside the network of doctors and still get coverage. Again, it
comes down to the cost and hassle factor: How much paperwork and
bureaucracy will you be dealing with? How many phone calls to a
glassy-eyed drone is it going to take to get permission to go to
an out-of-network doctor on your spouse's plan? If it's more than
what you're dealing with now, you may be better off staying put.
Ultimately, it boils down to weighing cost vs. flexibility.
Work out a nice balance and you could get better coverage and save
a little dough. Then you can start banking your pennies to help
pay for a whole new kind of dependent: kids.
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