Help! My Employer Just Dropped Spousal Coverage
Key Takeaways
Your company can remove spousal coverage, meaning they choose not to cover spouses (and only children) as dependents .
If you or your spouse lose coverage due to an employer dropping spousal coverage, you have options to secure coverage.
Looking into coverage with your employer is one coverage option to explore. Contact your employer’s Human Resources Department to inquire about coverage.
Purchasing individual health insurance is a highly customizable way to buy insurance that meets your health care needs.
Employers are Watching Their Bottom Line
As health care costs continue to rise, employers are exploring all options to cut costs and manage their health care spending. As part of the Affordable Care Act (ACA), employers can choose to offer medical insurance benefits only to employees and their dependent children, not to employees’ spouses — it’s called a spousal carve out. Still, this rule must apply consistently. An employer cannot discriminate by extending coverage to some employees’ family members but not to others.
Some employers apply spousal surcharges, a fee assessed if your legal spouse was on your employer’s plan but had access to coverage elsewhere. Others employ a more drastic measure: Cutting spousal coverage altogether.
If you or your spouse’s employer just dropped spousal coverage, you have options. Below, we’ve outlined two options you can look into today.
Find a local Medicare plan that fits your needs
Talk to Human Resources
If you were on your spouse’s health plan and can now no longer be covered, talk to your employer’s Human Resources Department. (Similarly, if your spouse was on your health plan and lost coverage, he/she should speak with their Human Resources Department.)
Because you lost coverage, you’ve experienced a Qualifying Life Event (QLE). This means you can enroll in your employer’s plan (assuming you meet other eligibility requirements as hours worked). Ask your Human Resources department for a Summary of Benefits and Coverage (SBC) and a cost summary of your plan’s benefits to determine if it’s the right fit for you.
Keep in mind that most employer-sponsored health plans only allow a 30-day window for you to enroll after experiencing a QLE.
Consider an Individual Health Plan
Individual health insurance plans offer flexibility and customization on a few different fronts. When shopping for insurance on a health insurance marketplace, you can:
- Tailor benefits to your specific health care needs.
- Pick a plan that includes your favorite doctors in-network.
- Find a plan that meets your budget. When it comes to individual health insurance, you have 60-days to enroll in health insurance after experiencing a QLE.
Are you eligible for cost-saving Medicare subsidies?
