If you’re getting divorced and you’ve been covered by your spouse’s health insurance, you’re probably going to lose that coverage.
Once the divorce is final, you can no longer be on your spouse’s plan. In most instances, you have a bit of time to figure out what comes next. But knowing what your options are will help you plan. Planning may just mean knowing how insurance will factor into your budget post divorce. But it may also mean negotiating for financial help from your spouse to get coverage.
Options for healthcare after divorce
So what are your options?
The first thing most people think of is COBRA, but it’s not the best option for many people.
COBRA temporarily extends your current health insurance plan for up to 36 months, so it provides some continuity. You’ll be able to maintain any deductibles you’ve met or out-of-pocket maximums you’ve reached.
But it comes at a cost. COBRA is the most expensive option of all the ones we have listed here. Unless you negotiate for your ex-spouse to cover the premiums, you’ll be footing the bill. And even if they do cover the cost, that money may be better spent elsewhere in your settlement agreement.
If you do choose COBRA, you usually have to apply within 60 days of your termination from your spouse’s health insurance plan.
Employer health insurance plan
For people who are currently employed, the best option is often signing up for health insurance with your employer. You probably won’t have to wait for an open enrollment period because divorce is a qualifying event.
Talk with someone from the human resources department at your company about how to sign up. Don’t wait too long because you may have a 60-day window after termination from your spouse’s plan. That’s the case for most of your new health insurance options.
Affordable Care Act
If you’re not employed or your employer’s health insurance plan isn’t a good fit, you may choose the Affordable Care Act (ACA), commonly referred to as marketplace insurance. Under the Affordable Care Act, you can purchase health insurance on a state or federal exchange. The exchanges are generally open between November 1 and December 15 each year.
But because of your divorce, you’re eligible to sign up on the state or federal exchange within 60 days of termination from your spouse’s health insurance plan.
When can your spouse remove you from health insurance
In most cases, your spouse technically can’t drop you off their coverage once the divorce has been filed (until it’s finalized).
However, as with most things, there are extenuating circumstances – like if your spouse changes jobs or retires or simply loses their insurance. If they have a change in their coverage, that would be an opportunity for them to not add you when they sign onto a new plan.
It’s also possible your spouse could try to remove you from their insurance plan anyway. If you are concerned about this, you should monitor your coverage
Issues to consider when choosing health insurance after divorce
As you’re weighing your options, there are few questions that will help guide your decision-making process/
How much does it cost? How much can you afford?
Determining the cost of a health insurance plan can be tricky. It’s more than just the monthly premium. One plan might have a low monthly premium but a high deductible. That could be problematic if you end up having an expensive procedure.
You need to look at the premiums, deductibles, co-pays, prescription coverage, and out-of-pocket maximums.
Depending on your coverage options, health insurance may be a big expense. The ACA offers subsidies for people that meet certain income eligibility requirements. If you’re concerned about your ability to afford health insurance, check out your options there.
Who’s in network?
You may already have doctors or care providers you like and feel attached to. In some areas, wait times for appointments as a new patient can be quite long.
If you want to make sure you can continue seeing the providers you already have, then check to see what insurances they accept. With that insurance company, that provider is considered “in network.” Sometimes you can continue seeing an out of network provider and file the paperwork yourself, but that can be a hassle.
Choosing a plan that allows you to continue seeing your favorite providers is the best option.
What type of plan makes sense?
Can you count on one hand the number of times you’ve been to a doctor in the last decade? A low-premium, high-deductible plan might be the best option for you.
On the other hand, if you know you’re going to have shoulder surgery in the next few months, a high deductible plan might cost you.
If you regularly see a mental health counselor or therapist, check to see how mental health services are covered under various plans.
We can’t always predict what our health care costs will be. But trying to anticipate based on what you know or your past experiences can help you make an informed decision.
Children’s health insurance after divorce
If your children were covered through your ex-spouse’s health insurance, they can remain covered. But you can also choose to change their coverage.
As part of the child support calculations, you and your spouse (or the judge, if you go to trial) will establish one parent’s obligation to maintain health insurance. That could be the parent whose insurance already covers the children, but it might not be. For whatever reason – financial or practical – it might make sense to put the kids on the other parent’s health insurance.
Whoever is paying for the children’s health insurance will get a credit for that payment as part of the child support calculation.
The divorce process is full of administrative challenges and decision making. A divorce lawyer can’t decide which health insurance plan fits your life. But working with an experienced divorce lawyer can remove much of the angst from the legal decisions you have to make.
At Porchlight, we help people have peaceful divorces and move on to the next chapter of their lives with as little drama as possible.