No, at a previous employer they were very specific about having your spouse carry their own plan if they could, rather than being treated as a dependent under your own plan.
Always pissed me off… seemed like none of their business how we wanted to set up our insurance if we could both be covered. If I want my wife on my policy, and not to carry the one at her job (or vice-versa), then that’s none of anyone else’s business.
I realize I may have misunderstood - yes, insurance companies want to know if there is any other entity that might be responsible for paying for any treatment ,not just for a spouse. If it’s a situation where my kids and/or I are covered both under my policy and my husband’s they will use "coordination of benefits " to keep me from being reimbursed more than I paid - but I’ve also been asked about other insurance in the case of injuries. When my son was hit in the face with a baseball, was he playing on a team that had insurance? Did I fall and sprain my ankle on someone else’s property so that their homeowner’s insurance was responsible?
When an employer won’t cover a spouse who can have coverage through their own employer (which is common) , that’s about the employer not wanting to pay the premium for the spouse. Although I’m not sure how they know whether people are lying about whether the spouse can get insurance. This is related to why some employers offer incentives to decline their insurance - if I had turned down my employer’s coverage and been covered under my husband’s employer’s policy my employer would have paid me an incentive of $3000 per year for opting out of family coverage or $1000 for opting out of individual. Of course, my husband’s employer doesn’t want to pay for my insurance so that my employer doesn’t have to , so some companies either don’t cover spouses with access to their own coverage or charge the employee the full premiums for those spouses.
When my wife took early retirement, she of course lost her own employer’s insurance, and we added her to my insurance. I had to submit a “Working Spouse Affidavit,” swearing that she had left her job and had no other insurance, and also submit proof of her separation from her job. The COBRA offer letter that she had received counted as sufficient proof of that.
In the case of a working spouse whose job doesn’t offer insurance, there was also a section of the Working Spouse Affidavit for that as well. One would have to get a signature from someone at the spouse’s place of employment, certifying that they did not provide health insurance. I don’t know how easy it would be to obtain such a signature.
I was an Actuary in Group Life / Health for 20 years; left the industry about 15 years ago, so my knowledge may be a little behind, but…
I’m not. Medicaid is set up SPECIFICALLY to cover those who can not be otherwise covered - i.e. unemployed / welfare / etc. You have access to other coverage - your employer’s medical coverage; you lose Medicaid.
Medicare is a little different, but I know the rules are similar - if you have another coverage, Medicare becomes secondary.
One of the stated benefits of ACA was “no pre-existing conditions”. Unfortunately, that doesn’t stop your employer from changing carriers; the new carrier expects you to jump through new hoops - “you have to try this medication first, then this one, then this one… then you can finally get the one that you’ve been using forever and ever.”
The good news is that if you’re able to keep your doctor, they can usually send documentation to the new carrier that you have gone through that process already and the lesser drugs don’t work for you.
If you can’t keep your PCP (Primary Care Physician for you un-American Godless heathen Socialist forigners who think they’re entitled to medical care), you may be able to get your records sent from the old doc to the new doc, who again could then submit proof, etc.
Yeah, it’s a pain in the patootie. I have often said that insurance companies don’t make money by paying claims, they make money by NOT paying claims.
Coordination of benefits. If they have coverage through their employer, their coverage is primary; yours is secondary (meaning fill-in-the-gaps). Of course they need a 37-page form signed in triplicate and notarized to prove that your spouse opted out of their own insurance because they have your coverage. We go through this crap EVERY TIME one of my kids has to go to the doctor - I have to prove that my wife still doesn’t have her own insurance and that the kids are primary on my plan, not hers.
Not sure that’s quite legal. If they offer dependent coverage, and you elect dependent coverage, they have to cover her. OK, to get more specific (and, again, might be a bit off on things changed with the ACA), they could offer dependent coverage as EE + SP vs. EE + Child vs. EE + Children vs. EE + Dependents. You choose EE + Dependent, your spouse is covered. Period. End of statement. Again, see COB stuff - the insurance company cares if Spouse has their own coverage because it lowers the amount of claims your insurance has to cover; your employer at that point has no say in the matter.
I’ve always heard (even here) that you don’t need to be a member to use the Costco pharmacy.
Pretty sure Atmasama is talking about OTC meds. I don’t think Costco gives people a break on co-pays for scrips.
And of course, “in bulk” has no meaning wrt prescription meds.
TTBOMK
Yup, I am. 
Under the ACA, large companies must cover children up to age 26 but there is no requirement to cover spouses and it doesn’t require that employers pay any part of the premium for dependents. There may be state laws that require employers to provide/pay for spousal coverage.