US Healthcare System Explained - Here’s How It WorksRead More
Even with the various legislation passed in an attempt for everyone to have health care insurance, it is still 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.
Using Your Health Insurance
Health insurance can be a tricky thing to understand. So, if you want to get the most out of your health care plan, it starts with going over the details.
For one thing, each insurance company has its own set of rules concerning how you receive care. Before you agree to sign up for a specific insurance, it is important to see the stipulations such as whether or not you can choose any doctors or hospitals, if vision and dental care come with it, etc.
Figuring out how to use your health insurance also deals with determining what your actual cost will be for coverage and how much your insurance company will cover.
Adding Someone to Your Insurance
If you want to use your health insurance to pay for someone else, it is possible to add individuals to your plan. 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.
Though you cannot add anyone you just live with like a roommate, it is possible to add a non-dependent to your health insurance if you wish for them to receive care. You can add a child that lives with you that you take care of as long as they are under the age of 21.
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. It is not generally possible to add an unborn child though, so you must wait until after the birth.
What you need to keep in mind about adding someone to your insurance is that if your spouse or child meets the requirements, you need to add them even if they are not in need of medical care and coverage.
Paying for Someone with Your Insurance
Since it is understood that you can add someone to your health insurance plan in order to get them coverage, the question remains if you can outright pay for someone with your insurance who is not on your insurance plan.
To use a simple answer: 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 see if common-law marriages are legal as those 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.
Now, if you want to pay for someone else you are not in relationship with, it is currently impossible to do without breaking the law. It concerns health insurance fraud, in fact. This is 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.