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Can You Use Your Health Insurance on Someone Else?

Health insurance is expensive, so it's no surprise that many Americans are looking for ways to get the most out of their coverage, but can you use your health insurance to pay for someone else?

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In recent years, there has been very significant legislation passed in an attempt to guarantee everyone access to health care insurance. Still, however, it is difficult for many to afford it. If you have insurance, you may be wondering if it is possible to use it to pay for someone else's treatment and care. In short, it is possible to pay for someone else’s treatment as long as they are included in your insurance plan, but there are a variety of rules that exist surrounding adding someone to your health insurance.

Who Can You Add to Your Health Insurance Plan?

If you want to use your health insurance to pay for someone else, you have the option of adding them to your health insurance. When signing up for insurance, go over their policy about adding your household members. If you are unsure who counts as a household member, it typically includes yourself, a spouse (if you have one), and the dependents you claim.

There are additional specifics when it comes to figuring out your household. For instance, understanding who can be a dependent (child, sibling, parent), how to file for a child dependent if you share custody, and more. Certain requirements exist for spouses as well, especially if they are separated.

An additional means of changing your insurance plan to cover someone else is if certain life events occur. To use an example, if you have a baby, you typically get up to 60 days to add them to your health insurance plan from the day that they are born.

When signing up for insurance, you should keep in mind that you are required to provide health insurance for anyone you claim as a dependent. If you list your spouse or child as a dependent, you need to add them to your plan, even if they are not currently in need of medical care or coverage.

What Is a Claimed Dependent?

A claimed dependent is an individual that relies on someone else for care and financial support. When it comes to health insurance, a claimed dependent most often refers to children who are under 26 years old. However, there are various other circumstances where an individual can be considered a dependent despite not being someone’s child.

A person can be considered a qualifying dependent under the following criteria:

  • They do not provide more than half of their own financial support during the tax year.
  • They do not have an income higher than the designated exemption amount.
  • They are not listed as a dependent for more than one individual.
  • They have a relationship with the health insurance policy holder.

It is possible for a policyholder to claim an adult dependent. Some common examples are parents, siblings or other relatives who are being provided caretaking services for financial or medical reasons. A qualified dependent is eligible to receive benefits under a policy holder’s insurance plan as long as they are listed as a dependent upon enrollment or added later.

Paying for Someone With Your Insurance

Now that it is understood you can add someone to your health insurance plan to give them coverage, and it is clear who qualifies as a dependent, the question still remains whether you can outright cover someone else’s medical expenses with your insurance if they are not listed on your plan. The short, simple answer is “No”. However, let's dive a little deeper into the legality behind paying for someone else's care with your insurance.

We know that if you have a spouse, they can be added to receive coverage. The question then comes up about those with domestic partners or if you have a "common-law marriage". First of all, check with your specific state to learn more about laws surrounding common-law marriages as they have their own cutoff date to be added to your insurance policy. For domestic partnerships, you also need to check with your specific state of residence to see how they enforce those laws.

If you want to pay for someone you are not in a legal relationship with, it is currently impossible to do so without breaking the law, as it is considered a matter of health insurance fraud. Health insurance fraud occurs when you have the insurance company pay for someone who is not listed under the policy. It is also considered fraudulent if you use your insurance to cover someone else's prescription costs.

If you want to help a friend or relative who does not live with you receive health care treatment, you can do so by gifting them your own money to help pay for expenses. You cannot utilize the insurance company for that.

Using Your Own Health Insurance Plan

Health insurance can be a tricky thing to understand. So if you want to get the most out of your health care plan, it is important that you understand your plan as well as possible by going over your plan’s details. Each insurance company has its own set of rules concerning how you receive care, so you should be sure to research.

Before you agree to sign up for an insurance plan, it is important to see the stipulations, like whether you can choose any doctor or hospital for care, whether the plan includes vision or dental benefits, and what you will have to pay into the plan. A crucial component of figuring out how to use your health insurance deals with determining what your actual cost will be for coverage, and how much your insurance company will cover. You should pay attention to the required deductible, your monthly premium and your required copay for various medical services.

Find the Best Health Insurance For You and Your Claimed Dependents

If you have a dependent or dependents to include on your insurance plan, it is critical that you find a plan that works best for your circumstances and your budget. Fortunately, FirstQuote Health allows you to compare health insurance plans to explore options and determine which plans best fit your needs. Get started today by comparing plans in your area and receiving a free quote.

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