Can you add spouse to health insurance after open enrollment

Open Enrollment for 2023 plans runs November 1, 2022 to  January 15, 2023. Enroll by December 15, 2022 for coverage that starts January 1, 2023. You have until January 15, 2023 to change plans. Outside of Open Enrollment, you can only change plans if you qualify for a Special Enrollment Period.

If you qualify for a Special Enrollment Period and want to change plans, you may:

• Have a limited number of health plan categories to pick from (instead of all 4)
• Need to select a new plan within the same plan category as your current plan for 2022 or you can change to a different plan category right now for 2023
• Be allowed to change plan categories under certain circumstances

Types of Special Enrollment Periods with limited plan category choices

Enrollees and their dependents (including newly added household members) who qualify for the most common Special Enrollment Period types — like a loss of health insurance, moving to a new home, or a change in household size — will only be able to pick a plan from their current plan category.

For example, someone who’s already enrolled in a Bronze health plan (and wants to change plans) will only be able to select a new plan from the Bronze category.

Circumstances that allow you to change plan categories

It may be possible to change to a plan in a different plan category during a Special Enrollment Period under certain circumstances.

Becoming eligible for cost-sharing reductions

If you become newly eligible for extra savings in the Marketplace called cost-sharing reductions (CSRs) and aren’t already enrolled in a Silver health plan, you can choose a plan in the Silver category to use your cost-sharing reductions.

Silver plans may also be available if you’re eligible for a premium tax credit and can enroll through a Special Enrollment Period based on estimated household income.

Losing cost-sharing reductions

If you’re enrolled in a Silver health plan and lose your cost-sharing reductions, you’ll qualify for a Special Enrollment Period. If you want to change plans, you can enroll in a Bronze, Silver or Gold plan that meets your needs and fits your budget.

New household members

If your household size increases due to marriage, birth, adoption, foster care, or court order, you can choose to add the new dependent to your current plan or add them to their own group and enroll them in any plan for the remainder of the year. Note: This only applies to the new household member. Current enrollees can’t change plans.

If you can’t add new household members to your plan

If your plan’s rules don’t allow you to add new members to your plan, your family can enroll together in a different plan in the same category. If no other plans are available in your current plan category, your family can enroll together in a category that’s one level up or one level down.

An employer offer to help with the cost of coverage

Gaining access to an individual coverage HRA or a QSEHRA from your employer to help with coverage costs doesn’t limit your ability to choose a new plan during a Special Enrollment Period. However, make sure you enroll in a plan that starts by the date your individual coverage HRA or QSEHRA begins, unless your employer offers a later start date.

Special Enrollment Periods for complex situations

Some Special Enrollment Periods, like those due to misrepresentation or plan display error, gaining or maintaining status as a member of a federally recognized tribe or an Alaska Native Claim Settlement Act (ANSCA) Corporation shareholder, or other very rare situations, don’t limit your ability to choose a new plan during a Special Enrollment Period. Learn about Special Enrollment Periods for complex issues.

When you purchase a health insurance plan for yourself, you can get coverage that extends to your dependents; likewise, if you’re an employer covering your workers, you can provide coverage for any dependents they have. If you’re planning on purchasing a family health insurance plan to cover your dependents, it’s important to make sure you know they’re eligible to join your family health insurance plan before you make your final purchase.

How do dependents work in health insurance?

A dependent refers to someone who is eligible to become an additional person on your health insurance plan. Your dependents can receive the benefits of your health insurance plan and use it in much the same way as you.

However, policies do not all read the same or have the same criteria for dependents, so it’s important to look into the details of your specific plan. It’s also important to note that if you’re an employer covering your workers, then some different rules can apply when it comes to dependents.

Who you can add to your medical insurance as a dependent will depend on the terms of your policy and the type of policy you have. But for the most part, you can add:

• Your current spouse
• All biological children and stepchildren
• Adopted children
• Foster children
• Children under your care who financially depend on you
• Children who can receive your benefits because of a court order

You can cover adult children up to the age of 26, but some caveats exist if your child is a college student. Some special circumstances can lead to dependent health care coverage, such as taking care of someone with a disability. Domestic partnerships can also lead to dependent coverage, but not always.

Dependents for taxes & health insurance

According to healthcare.gov, if you can count someone as a dependent on your taxes, they’re also a dependent on your health insurance plan. What’s more, you are required to provide health insurance for anyone whom you claim as a tax dependent. So if you intend to include a child or other relative as a tax dependent, you should also make sure they’re included in your health insurance plan.

Requirements for adding your children as dependents

If you have children, they’re probably the first people that come to mind when talking about dependents. Generally speaking, you can include any child who fits the following criteria:

• Age: Your child has to be under the age of 26.
• Relationship to You: For a child to qualify as your dependent, he or she needs to be your biological child, your stepchild, your adopted child, or a foster child you are taking care of. If your child has other sisters, brothers, half sisters, half brothers, or children of their own, you can also include them on your health insurance plan.
• Length of Residency: A child only qualifies as your dependent if they have lived with you for at least six months.
• Income Contribution: Although your child can be your tax dependent while working and contributing to their own expenses, they cannot be their own primary source of support. This means a child’s income must be less than half of the cost of their support expenses to qualify as your dependent.
• Tax Filing: A child cannot be your dependent if they file a joint tax return that year.
• Other Claims: A child cannot be claimed as a dependent by more than one household. So, regardless of your relationship, if someone else claims your child as a dependent, you cannot.

What’s not required to add your children as dependents

Besides keeping track of what’s required to claim your child as a dependent, you should also remember what isn’t required to claim a child as a dependent:

• Living with parents: Your child doesn’t have to be living with you at the time you enroll them in your health insurance plan, provided they’ve lived with you long enough to meet the residency requirement.
• Marital status: your child is still eligible for coverage if he or she is married or has children.
• Enrolled in school: it doesn’t matter if your child is enrolled or not enrolled in school.
• Eligible for employer-based coverage: you can still add your child to your health plan even if they chose to not enroll in their employer’s health insurance plan.
• Tax status: you can add your child to your plan even if you don’t claim them as a tax dependent.

As long as your children meet these other requirements, you can usually still include them in your coverage.

Adding your spouse as a dependent

In most cases, adding a spouse to your health insurance plan is acceptable. After getting married, you usually have up to 60 days to enroll in a new plan, or add your spouse as a dependent.

Keep in mind that if you or your spouse have access to employer-sponsored health insurance, but choose to buy your own family plan on a health insurance exchange, you likely will not qualify for Obamacare subsidies. Check out eHealth’s other resources to learn more about how health insurance works with marriage. If you have questions, you can also talk to one of eHealth’s licensed insurance agents to discuss coverage options that might fit your family’s needs.

Additional Dependents

Besides your child and spouse, you can include other relatives as dependents under certain conditions, namely:

• If no one else has named them as a dependent
• If their gross annual income is less than $3,000
• If you are responsible for providing more than half of the financial support they rely on

In addition to relatives, you can include others who have lived in your house for at least a year, provided they meet all of the aforementioned criteria.

Can you add your parents to your health insurance?

While the Affordable Care Act mandates that children be eligible for coverage under their parents’ insurance till 26, there isn’t a similar protection for parents. Health plans typically count spouses and children as dependents, but generally don’t include parents. However, the rules vary by plan and location, so always double check with your plan.

If you’re interested in getting health coverage for your parents, contact your health plan to find out if you can add them to your plan. Your parents must, generally, be claimed as tax dependents.

If your health insurance won’t allow you to add your parents, you can enroll them in a separate health plan, either through the Marketplace or Medicare (if they’re 65 or older). If you have questions about their eligibility or would like help finding coverage for your parents, eHealth’s team of trusted health insurance experts can go over your options.

Why should you add someone as a dependent for health insurance?

Healthcare is of the utmost importance to all people. However, health insurance offers other benefits as well. For example, health insurance offers you tax deductions and credits. So, who can I add to my health insurance plan for tax benefits? The same people you would add to your health insurance plan for health benefits.

Those same dependents recognized by your health insurance policy are usually also dependents in the eyes of the government. So, you can claim them when filing taxes and get tax benefits. Some of these tax benefits can include:

• Head of Household status
• Child Tax Credit and Additional Child Tax Credit
• Other Dependent Credit
• An increased Earned Income Tax Credit
• Deductions for medical and dental expenses for you and all dependents

You can also enjoy some tax exemptions. Credits reduce the amount of taxes you owe. Deductions reduce how much of your income is subject to taxes. Exemptions exclude certain amounts of your income from being taxed.

Also, the laws do change periodically, so it’s best to do some research and speak with a professional about the tax dependent aspects.

Who can I add to my health insurance: FAQs

Can you add someone who is not your spouse to your health insurance?

It depends on where you live. For example, some states allow you to add a domestic partner and the children of that domestic partner to your health insurance policies. In another state, that’s just not possible.

However, most times, you can claim someone as a dependent if you provide over half of the financial support for them, have a court order to do so, or take care of them in a substantial way. A dependent has to meet the qualifications as set out by the healthcare provider, state law, and federal law. The IRS Code supersedes other laws and plan rules.

Who can I add to my insurance as a qualified dependent?

• Policyholder’s child under the age of 26
• A child you have a defined relationship with and provide over half of the financial support for
• A relative you have a defined relationship with and provide over half of the financial support for
• Someone you must include in your plan because of a court order or exceptional circumstances

State laws and policy rules can modify the dependent criteria, but they can only really add to the IRS Code, not take away from it.

Can you put friends on your health insurance?

Except where common law marriages and domestic partnerships are allowed, you cannot add dependents that aren’t relatives to you. A family health insurance plan will not allow you to add a friend unless that friend can fit the relationship criteria for a dependent.

Coverage Considerations

Once you have named someone as your dependent, he or she will generally have access to the same plan or set of plans that you use. Depending on where you get your health insurance, he may also be able to choose among plans that you rely on, including the health plan, dental insurance, vision, or more.

Protecting the health of your loved ones with quality health coverage is one of the most important things you can do for them. eHealth is committed to helping you understand all the nuances of health coverage. Our trusted and knowledgeable licensed insurance agents are here to help you find coverage that fits your needs and budget. For more information, visit eHealth.com, where you can tap into our information on health insurance or start looking at family health insurance plans. We make it easy to browse and compare plan benefits and costs in one place.