not the worst problem
May 25, 2023 11:55 AM   Subscribe

I just became eligible for much cheaper health insurance so we can stop using my husband's expensive work plan (or can we?) (US-based, in case not obvious)

We are currently both covered under my husband's work plan. I got a new job with better benefits than my husband's. Are we both eligible to switch to my work place's plan?

I found this question but our situation is slightly different. I just started this job Monday and was eligible for health insurance on Day 1, whereas this poster had waited till open enrollment.

If we can't switch now in the middle of husband's health plan year, when would we be able to? open enrollments don't overlap. Neither of our HR departments inspire much confidence so we feel the need to know the answer going in. Where would I have found the answer to this question if I was better at googling?
posted by Tandem Affinity to Health & Fitness (7 answers total)
Generally starting a new job is a qualifying event. Whether that covers your husband too is somewhat down to location, plan, and yes HR. (Where I live, it would cover your husband. You can probably find out by googling your location + insurance + qualifying event + spouse.)
posted by Bottlecap at 12:01 PM on May 25 [6 favorites]

This is plan specific, your husband will have to ask his HR. If they allow drop due to a spouse QLE, then you're fine.

If they don't allow it, then the next opportunity will be when husband has open enrollment. He waives coverage for the new plan year and this loss of coverage becomes a mid year QLE for your plan.
posted by phunniemee at 12:05 PM on May 25

If the cost isn't too bad, I would add both of you to your new work plan now. Once that is in place, you can see if you can at least drop the spouse/family coverage from your husband's work. Googling is mostly focused on events that allow you to add someone, not drop them. With private insurance if you stop paying you get dropped so it might be possible. HR should be able to tell him the answer. At the minimum, you will then be set up to drop your husband's plan when it starts the new open enrollment.

In the meanwhile, you will both have two insurance plans. So, when someone has a medical expense, they first file the claim with their primary plan (the one from that person's own employer). Whatever isn't covered by the first plan can then be submitted to the second plan and they will pick up some or all of the remaining costs.

By the way, when you have two plans, it is important to do a COB (Coordination of Benefits) to tell each insurance company about the other. They then have rules for who is primary although it is pretty clear in your case. Often you can find the form on the insurance companies web site. Not doing this can cause hold-ups and headaches later.
posted by metahawk at 12:06 PM on May 25 [2 favorites]

Coverage under your new job is a qualifying life event and you can be removed from your husband's insurance. He can also likely drop his own plan at the same time - qualifying life events are pretty broad in my experience.

However, some employers charge an extra fee if their employee's spouse has coverage under their own work plan. It can be a significant fee - like $70-$100 per month in my experience. So check that with your employer before switching your husband over.
posted by muddgirl at 12:13 PM on May 25

Response by poster: oh wow thank you for all the quick responses. it would be ok if my husband has to stay under the old plan -- as long as I'm free to change, that's my main worry. and i think you are all agreeing that i can switch. I haven't been able to find that eligibility for new coverage (i.e., my new job coverage) makes me eligible to stop using his employer's plan.
posted by Tandem Affinity at 12:30 PM on May 25

My husband's work insurance expressly forbids adding a spouse who is eligible for coverage via their own job. We have to sign a form every year that says I don't have work insurance. I happen to be self-employed, but if i worked at an outside job, I'd need to have that HR dept. sign my form as well. So I think you need to dig deeper into exactly what your new plan has to say about that.
posted by BlahLaLa at 2:41 PM on May 25 [1 favorite]

If, per your second post, all you are worried about is being able to drop your old insurance, dropping insurance is always your choice. I have never heard of an employer wanting to stop anyone—employee or employee’s dependent, who wanted to drop their coverage
posted by Lylo at 10:43 PM on May 26 [1 favorite]

« Older How to bind a sheaf of paper together?   |   How to interview: medical social work edition Newer »

You are not logged in, either login or create an account to post comments