Orlando Harmon
Divorce is a challenging transition that involves sorting out many issues, including health insurance. When a couple is married, they are often covered under one health insurance plan, typically provided through an employer. Once divorced, the non-policyholder spouse is no longer considered a family member and loses coverage under the existing plan. This means they must find new insurance coverage and pay their own premiums. However, there are several options available to continue health insurance coverage after a divorce, including enrolling in a new insurance plan, applying for government programs like Medicaid, or, in some cases, continuing coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA) for a limited time.
| Characteristics | Values |
|---|---|
| If you are the insurance policyholder | You won't lose coverage after a divorce, but you need to notify your insurance plan about your divorce |
| If you are not the insurance policyholder | You will have to find new insurance coverage and pay your own premium |
| Temporary restraining orders | Some states automatically issue them to maintain the financial status quo during the divorce process, prohibiting either spouse from changing or canceling health insurance policies |
| If you have children | They can stay covered under your spouse's plan |
| If you are working | An employer-sponsored health plan might be an option |
| If you are not working | You might want to look for a job that provides health insurance |
| If your financial situation has changed due to divorce | You might qualify for Medicaid |
| If you are in relatively good health | You may want to get your own health insurance |
| If you are in poor health | You may want to consider COBRA coverage, but this may make it difficult to find good health insurance once it expires |
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What You'll Learn
- If covered by your spouse's insurance, you will be dropped from the plan
- You can stay on your ex-spouse's employer-sponsored coverage through COBRA
- Divorce is a Qualifying Life Event (QLE) for insurance purposes
- Courts may issue temporary orders to maintain the financial status quo during divorce
- If you can't afford health insurance, consider applying for Medicaid
If covered by your spouse's insurance, you will be dropped from the plan
If you are covered by your spouse's insurance, you will almost certainly be dropped from the plan after a divorce. This is because the non-policyholder spouse is no longer considered a "family member" or dependent and is therefore not eligible for coverage under their ex-spouse's plan.
In the case of employer-sponsored health plans, the covered spouse and any dependent children will need to consider their options for health coverage. If the non-policyholder spouse has an employer health plan available at work, they and their dependents may be eligible to special enroll in that plan. Alternatively, they may be able to special enroll in health coverage through the Marketplace.
If you are in relatively good health, you may want to consider purchasing your own health insurance. A licensed insurance agent can help you navigate your options and find a plan that fits your budget and covers your specific needs. Divorce is considered a Qualifying Life Event (QLE), which means you can change your health insurance plan outside of the usual annual enrollment periods.
If you were covered by your spouse's employer-sponsored health plan, you may be able to continue your coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA is a law that requires group health plans to offer temporary continuation coverage in certain situations, such as divorce. However, you will be expected to pay for this coverage, and finding a new plan after the temporary coverage period ends may be difficult if you have a pre-existing condition or past health history.
If your financial situation has changed due to the divorce, you may qualify for Medicaid, a government insurance program that provides free or low-cost health care coverage to low-income individuals and families.
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You can stay on your ex-spouse's employer-sponsored coverage through COBRA
If you were covered under your spouse's employer-sponsored health plan, you will likely need to find new health insurance after your divorce. However, you may be able to stay on your ex-spouse's employer-sponsored health insurance through COBRA (Consolidated Omnibus Budget Reconciliation Act). COBRA is a federal program that allows employees and their families to maintain health coverage after experiencing certain qualifying events, such as divorce or the death of the covered employee.
COBRA typically applies to employees who are terminated from their jobs, enabling them to retain their health insurance. However, in the event of a divorce, a spouse and their dependent children may also qualify for COBRA coverage. This means that they can continue their existing health coverage for up to 36 months after the divorce. It's important to note that you have a 60-day window to enroll in COBRA, starting from either the date of your divorce or the date you receive a COBRA election notice, whichever is later.
To initiate the process, you must notify the plan administrator of the qualifying event (divorce or legal separation) within 60 days. Subsequently, the plan administrator is responsible for notifying the qualifying beneficiary of their right to elect COBRA continuation coverage within 14 days.
COBRA coverage can be beneficial if you need time to explore long-term coverage options or if you're transitioning to a new job that provides health insurance. However, it's important to note that COBRA coverage may be more expensive than your previous coverage, as you may be responsible for paying the entire premium yourself.
Additionally, if your spouse works for a smaller employer, you may still have options to extend your coverage. Many states have "mini-COBRA" laws that apply to employers with 19 or fewer employees, allowing you to purchase health insurance under the Affordable Care Act (ACA).
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Divorce is a Qualifying Life Event (QLE) for insurance purposes
Divorce is a major life change that can have a significant impact on your health insurance coverage. It is classified as a Qualifying Life Event (QLE) by insurance providers, allowing you to make changes to your health insurance plan outside of the usual annual enrollment periods. This means that you can enroll in a new insurance plan or make adjustments to your existing coverage. Here's what you need to know about how divorce affects your insurance and the options available to you:
Impact on Spousal Coverage:
If you've been covered under your spouse's employer-provided insurance, you will likely need to find new health insurance after the divorce. Once the divorce is finalized, you are no longer considered a "family member" or dependent on their plan and will need alternative coverage. In rare cases, an insurance plan administrator may allow you to remain on your ex-spouse's plan, but this is not common.
Special Enrollment Period (SEP):
Due to divorce being classified as a QLE, you become eligible for a Special Enrollment Period (SEP). This means you can enroll in a new insurance plan outside of the standard Open Enrollment Period. You typically have 60 days from the date of your divorce to make changes to your health insurance. During this time, you can explore different options and choose a plan that suits your needs and budget.
Employer-Sponsored Coverage:
If you are employed, your employer's health plan might be the most convenient and affordable option for you. Speak with your employer about enrolling in their health insurance plan and the coverage details, including dependent coverage if you have children. Even if the level of coverage is not as comprehensive as your previous plan, it may still be a practical choice, especially if it is more cost-effective.
Consolidated Omnibus Budget Reconciliation Act (COBRA):
The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you to temporarily continue your coverage under your ex-spouse's employer-sponsored plan for up to 36 months after the divorce. This option ensures that you maintain your existing health insurance during the transition. However, you will need to pay the premiums yourself, which can be expensive.
Medicaid and Other Government Programs:
If your financial situation has changed due to the divorce, you may qualify for government-run programs like Medicaid. Medicaid provides free or low-cost health insurance to low-income individuals, families, and children. It also covers pregnant women and people with disabilities. Eligibility requirements and benefits vary by state, so be sure to check with your state Medicaid agency or consult a licensed insurance agent to explore this option.
Remember, it is essential to plan ahead and understand your options to ensure you have continuous health insurance coverage during and after your divorce. By knowing your choices, you can make informed decisions about your health insurance and choose a plan that best suits your needs.
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Courts may issue temporary orders to maintain the financial status quo during divorce
When a couple decides to divorce, they both remain insured on the existing plan during the divorce process. However, once the divorce is final, the non-policyholder is no longer considered a family member and is not covered by the plan. That spouse will have to find new insurance coverage and pay their premiums. If you were covered by your spouse's employer, you will almost certainly have to find new health insurance.
To ensure that the financial status quo is maintained during the divorce process, courts may issue temporary orders. These orders are meant to prevent situations where one party suffers financial hardship as a result of separating from their spouse. They also prevent either spouse from taking certain actions, such as changing or canceling health insurance policies. Temporary orders typically last until the divorce is finalised.
In some states, courts automatically issue temporary orders (sometimes called "temporary restraining orders" or "temporary injunctions") when someone files for divorce. If you live in a state that doesn't automatically issue these orders, you'll have to request that a judge issue one that addresses health insurance and any other relevant issues. Temporary orders can be requested at any time by either party and provide a measure of financial certainty during a stressful time.
In addition to maintaining the support of the other party, a party cannot excessively spend money or incur substantial debt when contemplating a divorce or during the divorce process. If a party fails to maintain the status quo, the other party can bring a claim of "dissipation of marital property" and be awarded compensation for the dissipated property in the resolution of the divorce.
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If you can't afford health insurance, consider applying for Medicaid
Divorce can be a challenging transition, and it is important to plan ahead to make this life-changing transition a bit smoother. One of the most important things to stay on top of is your health insurance. If you were previously covered by your spouse's insurance, you will almost certainly have to find new health insurance.
If you cannot afford health insurance, you should consider applying for Medicaid. It is a government insurance program that provides free or low-cost health care coverage to some low-income individuals, families, and children, older people, pregnant women, and people with disabilities. Medicaid benefits and program names vary between states, and eligibility depends on your income in comparison to the federal poverty line (FPL). In some states, having insurance is legally required, and residents could face tax penalties if they are uninsured.
You can apply for Medicaid through the Marketplace or contact your state Medicaid agency. If you do not qualify for Medicaid, you may still be able to pay very low premiums and out-of-pocket costs for private health insurance through the Marketplace. You can also apply for a premium tax credit or other cost savings for a Marketplace plan. If your state hasn't expanded Medicaid and you are deemed ineligible, you may have fewer options for coverage.
It is recommended that you get help from a licensed insurance agent or a divorce lawyer to negotiate your health coverage during divorce proceedings and to find a plan that fits your budget and covers your needs.
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Frequently asked questions
If you were covered under your spouse's insurance plan, you will likely have to find new insurance coverage and pay your own premium. Very few health plans consider ex-spouses to be "family members" who are eligible for coverage.
If you are working, an employer-sponsored health plan might be the easiest and most affordable plan for you. You can also see if you qualify for Medicaid, which provides free or low-cost health insurance to low-income families. If you got your insurance through your spouse's employer, you may be able to continue it through COBRA for up to 36 months.
If your financial situation has changed due to your divorce, you might qualify for Medicaid or the Children's Health Insurance Program (CHIP). You can apply through the Marketplace or contact your state Medicaid agency.
Although your kids can stay covered under your spouse's plan, you will need to notify the plan administrator to remove yourself from the plan. Your children may also be eligible to continue their existing health coverage for up to 36 months.
