Divorce and Health Insurance Benefits

Many married couples experience financial hardship following a divorce. However, many divorced individuals are also eligible for health insurance through their ex-spouse's plan if they remain in the same health insurance network. The post outlines what health insurance coverage steps an individual can take to ensure that their spouse does not receive misinformation about how much spousal coverage they might be entitled to.

Unfortunately, there is not any one single set of rules that apply to all types of divorces, and it is important for former spouses to explore available options with their divorce attorney or family member in order to make the best decisions for themselves and avoid surprises down the road.

The following is an outline of the different health insurance options for divorced individuals. The discussion includes information about the application process, as well as how to obtain further information about coverage and benefits packages from your ex-spouse's health insurance provider.

Spousal Continuation of Health Insurance Coverage

If you were covered by your ex-spouse's employer-sponsored health insurance plan at any time during your marriage, you may be entitled to continued coverage (depending on the type of divorce) under COBRA. Under COBRA, divorced individuals can extend their own group health plan coverage for 18 months beyond divorce or two years if they have a child together. For individuals with coverage under their ex-spouse's plan, COBRA provides a way to extend your own health insurance coverage for up to 18 months.

If you have a child that was born or adopted during the marriage, COBRA provides special protections including the option to add the child's name to your current plan. Additionally, COBRA provides slightly more generous income and asset guarantees, which may be appealing to those caught in the middle of a long-term legal battle. However, COBRA is generally not available if you were covered by an employer's group health insurance plan before your marriage; or if your divorce was based on fault or on desertion (i.e., a prolonged absence).

Check with your former spouse's plan to see if you are required to provide proof of COBRA enrollment within 60 days. If you miss the deadline, you may lose out on your ability to continue coverage under your ex-spouse's plan.

Qualifying for Benefits on a Former Spouse's New Plan

If you are covered by an employer-sponsored health insurance plan through your new spouse's company, and/or are not eligible for COBRA coverage from your ex-spouse, you may be entitled to enroll in a spouse or child-only group health insurance plan through your new spouse's employer. Under the ACA, employers must offer certain employees the opportunity to enroll in such plans.

A spouse or child-only plan may offer lower monthly premiums than the group health insurance plan offered by your ex-spouse's employer; however, it does not cover all of the same benefits and is not guaranteed to continue indefinitely. While eligibility to enroll in a spouse or child-only plan does not require a medical evaluation, employers are generally required to make an effort to verify the marital status of individuals applying for coverage.

Check with your former spouse's employer to see what plan they offer.

Enrolling in an Individual Health Insurance Plan in Another State or Country

If you are not eligible for COBRA coverage, you may be able to buy an individual health insurance policy ("IHIP") in another state or country. However, there are very limited circumstances where this option is available and is likely the best choice for an individual seeking health insurance coverage outside of their own state or country. In order to buy an IHIP regardless of where your spouse lives, the host state must allow for interstate sales of this type of policy.

Check with your new spouse's employer to see if they offer a spouse or child-only policy. If they do not, you may wish to check with your state's insurance department to find out whether an IHIP is available in your state. You may also check with the National Association of Insurance Commissioners website for a list of states where such plans are available.

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Disclaimer The information provided on this page is intended for educational purposes only and should not be construed as legal, medical, or financial advice. The content of this blog post is the opinion of the author and should not be regarded as representative of the opinions or positions of the author's employer. While we aim to be accurate, readers who fail to seek individualized legal, insurance, or other professional advice prior to acting on any information contained in this website do so at their own risk. We are not responsible for any losses caused by reliance on any information contained in this website.

Sources: DOL, HealthCare.gov, National Association of Insurance Commissioners, U.S. Department of Labor [1], USNews.com [2]

Image Credit: Bankrate.com [4]

Note: These are general guidelines and are not meant to be legal or financial advice. You should consult with your own attorney or financial advisor for specific advice as to the impact of these issues on your individual situation and needs.

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Conclusion

The rules and regulations surrounding insurance coverage for co-related spouses can be confusing. Feel free to contact us with any questions you may have.

Image Credit: Adobe [6]

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