Obamacare: one plan for both spouses, or one plan per person

I’m 51 and my wife is 47.  Under what conditions would my wife and I be better of getting two individual low deductible/low out-of-pocket plans vs one identical family plan, if the total premiums are identical?

Figuring It Out In Florida

Dear Figuring It Out In Florida

Given that you have just two adults to be covered, there is no gain to having one rather than two plans.  You would not gain any advantage, such as a joint deductible.  The deductible and annual benefit limits are per person. And, as you point out, the cost of one plan versus two may be identical.

You might get some other minor conveniences from buying one plan that covers you both.  You would have one enrollment process, one monthly bill, one set of co-pays to deal with, etc.

On the other hand, if you and your wife have different health needs, then you might be better off with two separate plans.  For instance, if one of you has diabetes, then the plan’s coverage for supplies and medications would be important.  If one of you takes no medications but is a cancer survivor, then the plan’s coverage for oncology specialists would be important.  You have the freedom to choose a plan that meets your individual needs, but that may not meet your spouse’s needs.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.