Adding spouse to health insurance without social security number

Investigating your options 

Jenny came into our Austin store for help with health insurance. She was visiting the United States for a period of time and therefore didn't have a social security number (or any document as proof of US residency).

Unfortunately, she ran into a concerning situation where she needed to see a cardiologist.  

Have you been in a situation like this before? How scary to be in need of care but not have major medical insurance. 

What to do when you don't have a social security number & need medical care 

The quick answer is you can't get major medical insurance if you don't have a social security number. One catch: lawfully present immigrants can purchase health insurance without a social security number, but you'll want to read all the details here because it is by no means a quick process. If you are just visiting the United States and run into a health concern, you can't purchase a plan on HealthCare.gov or through the individual market.    

Even though there are limited options for people without social security numbers here in the US, there are options. The best strategy is to purchase US Visitor health insurance and then search for low-cost providers that have discounts for paying out-of-pocket for medical costs. 

Visitor Insurance 

Visitor Insurance can be purchased if you don’t have a social security number yet. This insurance works more like short-term health insurance in that it is catastrophic in nature and doesn’t cover pre-existing conditions. 

In other words, Visitor health insurance will cover you if you are in a terrible accident, but not any health conditions that existed prior to you purchasing the insurance. And most likely visiting the doctor or filling your prescriptions will be very expensive under this type of insurance, because remember, it’s just supposed to cover you in the case of medical emergencies. 

In this case, Jenny had Visitor Insurance but needed immediate medical attention for her heart and there weren’t any health plans that would cover her needs. 

Research cost-effective ways to pay out-of-pocket

The next step is to research the most cost-effective way for you to pay out-of-pocket for the services you need. Research will save you a lot of money. You'll want to look into the prices of the providers near you that offer a discount for people without insurance. You may even want to do a 100 or 200 mile radius (depending on how comfortable you are traveling) because health prices can vary drastically.  

Many physician’s practices give a 30-35% discount to out-of-pocket payers. Additionally, there are many who allow these patients to make monthly payments spreading the payments out over a year or longer. 

We looked into the best strategy where Jenny could see a cardiologist in Austin and pay out of pocket. See two possible options for Jenny below: 

Adding spouse to health insurance without social security number

We recommended: Paying out of pocket for services at Austin Heart Hospital in Lakeway. Why? Because it's the most affordable option for Jenny both because of the the 35% discount for those without insurance and because of the lower prices for the medical procedures needed. 

New Patient Office Visit: $200-$500 

EKG: $60.00

ECHO: $150

No insurance out-of-pocket discount: 35% off

This option worked for Jenny's case. She was able to get the medical attention and peace of mind she needed. But your situation may be completely different. Researching cost-effective options may be a huge headache, but it will save you in the end. 

If you liked this post, you may also like 4 signs a short-term health plan is right for you.

Can I add my spouse to my health insurance if he is not a US citizen?

When a family with mixed immigration status applies for health insurance, it only has to give citizenship and immigration status for those family members applying for coverage. Non-applicants, such as a parent applying for a child, do not have to provide citizenship or immigration status.

Can I add a non US citizen to my insurance?

Yes, as long as they're lawfully present in the U.S. (Note that there is one exception: DACA recipients are considered lawfully present during their deferred action period, but they are not eligible to enroll in health coverage through the exchange.)

Can I use my ITIN number to get health insurance?

You may be able to use your Individual Taxpayer Identification Number (ITIN) to apply for health insurance in place of the SSN. Most insurance plans are focused more on your current residence than your SSN.

Do I have to give my social security number to my insurance company?

You are not required by law to give out your social security number. If you feel uncomfortable doing so, it's good to remember that in most cases, your insurance adjuster won't need it.