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Frank Serritella

In this article, we will explain how to obtain health insurance after a divorce.  We will explain the impact of a divorce on your health insurance and your options for obtaining new insurance if you were previously covered under your ex-spouse’s plan.  

What Your Divorce Means for Your Health Insurance

While maintenance and child support are two subjects given high consideration when an individual begins the divorce process, health insurance may not be given that same level of attention. While the terms of a marital settlement agreement often contain provisions allocating responsibility for health insurance coverage of the parties’ children, the terms don’t often include coverage for the soon-to-be former spouse. Why? Most health insurance policies do not include former spouses as eligible for coverage on an insurance policy.

The former spouse that stands to lose health insurance may be in such a precarious situation due to the parties’ former lifestyle (For example, the former spouse may have been a stay-at-home parent or unemployed).

Insurance Options for After a Divorce for Uncovered Ex-Spouses

Insurance Options for After a Divorce for Uncovered Ex-Spouses

If you are uninsured after your divorce, you have two primary options for health insurance: coverage under the Affordable Care Act or COBRA.  

Affordable Care Act After Divorce

To enroll in a health insurance plan through the Affordable Care Act (or private insurance companies), one has to enroll during the the designated “open enrollment” period. However, there are options for special enrollments where an individual loses coverage during non-“open enrollment.” An exhaustive list of special enrollment factors can be found at www.healthcare.gov but the general rule is that an individual has sixty (60) days from the day they lose coverage to apply for new coverage as a special enrollment.

Healthcare.gov Coverage-Qualifying Events:

  • Loss of health coverage;
  • Change in household structure (marriage, birth of child, etc);
  • Change in residence; or
  • Other qualifying events.

For a more in-depth overview of qualifying events: https://www.healthcare.gov/glossary/qualifying-life-event/

COBRA Coverage on Your Ex-Spouse’s Plan After Divorce

The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows to you maintain coverage on a former spouse’s health insurance plan for a period of up to thirty six (36) months from the date coverage is lost. Similar to the ACA above, COBRA coverage requires certain qualifying events are met such as losing coverage through an employer or losing dependent status of the covered employer.

While COBRA coverage is a positive situation in that the individual maintains a health insurance plan they’re comfortable with and presumably confident in, the cost is very high. The employee seeking COBRA coverage will be responsible for all premium payments, including the share the employer used to cover, as well as administrative fees.

An individual is eligible for COBRA coverage if he or she:

  • quits or is let go from the job;
  • has his/her work hours reduced;
  • becomes eligible for Medicare;
  • is divorced or legally separated;
  • dies; or
  • children age out of dependent status.

In sum, health insurance coverage after a divorce is an important issue that should be planned for before the divorce is finalized.  How the coverage will be obtained and which party will pay for it is an issue for negotiation in the marital settlement agreement, just like spousal maintenance and parenting issues.

Disclaimer: The information provided on this blog is intended for general informational purposes only and should not be construed as legal advice on any subject matter. This information is not intended to create, and receipt or viewing does not constitute an attorney-client relationship. Each individual's legal needs are unique, and these materials may not be applicable to your legal situation. Always seek the advice of a competent attorney with any questions you may have regarding a legal issue. Do not disregard professional legal advice or delay in seeking it because of something you have read on this blog.

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