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Is your spouse considered a dependent on health insurance?

A brief overview...
  • Your spouse is considered a dependent on health insurance
  • Opposite sex, same sex, and unmarried partners may be able to apply for health insurance
  • Spouses must be added to health insurance coverage immediately after marriage

When you fill out an application for health insurance, you have to list the primary insured’s name and all dependents. But, who’s a dependent? That question has led many to fill out applications incorrectly or leave someone off the application that is eligible for coverage.

Most errors in an application have to do with your spouse is considered a dependent when filling out an insurance application. If an employer offers employees health coverage, and the employee works full-time, the employer must also provide coverage for the employee’s family including his dependent children and spouse.

Regarding group health insurance, a dependent is a spouse, child, and in some cases unmarried domestic partner of the employee. However, an employee’s dependents cannot enroll for coverage if the employee is not enrolled.

Find health insurance for you and your spouse by comparing quotes with our free tool above!

Legal Spouse Definition

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Under group health coverage, an employee’s legal spouse qualifies for health insurance. Traditionally, a person’s spouse was either their wife or their husband. Today, the definition of legal spouse is still a person’s wife or husband, but same-sex marriages are recognized in the United States, which means same-sex spouses are acceptable relationships regarding gaining health insurance.

Unmarried Domestic Partners

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Some employers offer health care benefits to unmarried domestic partners of employees. If this type of insurance is provided to an employee’s domestic partner, it must be equivalent to what is offered to a married spouse. Domestic partner relationships are defined by employers and can include:

  • Unmarried same-sex partners
  • Opposite-sex partners
  • Both same sex or opposite sex partners

Under most circumstances, both the employee and their domestic partner must sign an affidavit of domestic partnership. The affidavit is designed to establish that the couple lives together and are in a committed relationship. The affidavit also clearly states that the couple intends to remain in a committed relationship indefinitely.

The purpose of the affidavit is to deter people from fraudulently applying for insurance coverage as domestic partners if they are not in a committed relationship. For example, roommates or people who share the same living space but are not in a committed relationship are not eligible to apply for health insurance as unmarried domestic partners.

When can I add a spouse to my health insurance policy?

Spouses can be added to an employee’s health insurance when the employee applies through his or her employer. If the employee is already working and is covered by the employer’s group health insurance, the employee may be able to add their wife or husband through “special enrollment.”

What is special enrollment?

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Just like with children, most insurance companies offer special enrollment periods for insurers to add new members of their family. For children, when a baby is born, it can be immediately added to a parent’s health care insurance. For adults, a spouse can be added if any of the following occur:

  • New marriage
  • Divorce
  • Spouse had their coverage, and it has ended

In the situations mentioned above, the employee would have to fill out enrollment forms for their spouse to be added. It’s important to add a spouse to your insurance policy as soon as you are married because many insurance policies will only allow a spouse to be added for an indefinite amount of time.

If the spouse is not enrolled in the system during a certain period, the employee’s spouse will have to wait until the next open enrollment period to apply for coverage.

Another factor to consider when adding your spouse to your health insurance coverage is whether your spouse is already covered by their policy?

What if my spouse already has insurance?

Your spouse can be added to your health insurance policy as a dependent, even if they have coverage through their policy. If a spouse has their insurance policy, it may be necessary to way the pros and cons of adding them to an additional policy.

Many insurance companies don’t allow for overlap between plans. If either you or your spouse’s insurance company don’t allow for overlapping policies, there may not be a benefit to adding each other to your group coverage.

Not all health insurance companies or employers extend benefits to employees and their dependents in the same manner. If you have any questions about coverage and whether your insurance will cover all of your dependents, it’s important to examine the policy and speak with an agent or broker if needed.

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