Maintaining Your Health Insurance After Divorce

maze.gif (2707 bytes)Your health is the most important asset you have, and health insurance coverage is a close second.

If your health insurance is through your spouse’s employer, once the divorce is final you will need to obtain health insurance for yourself. It is very important that there is no gap in coverage, so you must deal with the issue early in divorce negotiations.

COBRA – It’s a Federal Law, Not a Snake

While your spouse may be required by the court to keep the health insurance for the children, he or she will be unable to maintain the health insurance for you after the divorce.

If your spouse works for a company that employs 20 or more people, then you are eligible to apply for continued health insurance coverage in his employer’s plan under a Federal law known as “COBRA” (Consolidated Omnibus Budget Reconciliation Act).

If the company has fewer than 20 employees, you might still be eligible for continued coverage under the mini-COBRA coverage laws of your state.  Most states have mini-COBRA, except Alabama, Alaska, Arizona, Delaware, Idaho, Indiana, Michigan, Montana, Pennsylvania, Virginia, and Washington. State mini-COBRA terms can differ quite significantly from those provided by the standard federal COBRA, so you’ll need to research the coverage terms and eligibility rules. Here’s a helpful website: http://www.cobrainsurancedirect.com/COBRA-Insurance.html

The 60 Day Rule

Your spouse’s employer is required to provide COBRA coverage for you, but only if you notify the health plan administrator within 60 days of becoming divorced. If you don’t give the administrator proper notice, then you will not be eligible for COBRA coverage.

Coverage Through Your Own Employer May be Cheaper

You may not want to be covered under COBRA if you can obtain health insurance through your employer. This is because your spouse’s employer is probably paying for all or a portion of your current health insurance premium.

Under COBRA, you will be responsible for the entire amount of the premium. (Actually, you may be charged 102% of the cost of the group rate.)

If your employer provides health insurance for you at little or no charge to you, then you are better off obtaining health insurance through your employer. But, for people who do not have this option, COBRA may be their only viable choice.

Before you opt for the COBRA coverage, check out other private plans such as Blue Cross, to compare the benefits and the cost. You may find options that are less expensive and more permanent than the COBRA coverage.

One way to find a list of these private insurers is to ask the personnel at your doctors’ offices what insurance plans they accept, and which ones make payments that are the most hassle-free.

COBRA Coverage Ends in 36 Months

COBRA coverage for a former spouse ends within 36 months. So, you need to be prepared for this coverage to end and new health insurance to take its place.

If you have questions about the impact of preexisting conditions on obtaining new health insurance once the COBRA coverage expires, you should contact someone who is knowledgeable about the different kinds of health insurance plans available in your area.

If you are healthy, consider a private plan rather than taking the COBRA coverage for three years. If you took the COBRA coverage and became ill during the three-year period, you might find that you were uninsurable at the end of three years, when the COBRA coverage expired. A private plan, rather than a group plan under COBRA, would facilitate continuing coverage and might be worth any extra expense.

Note: This information is not to be considered legal advice to create an attorney-client relationship. Laws and practices vary from state to state. Taking legal information out of context generally has negative consequences. If you have questions relating to your particular matter, you should contact an attorney in your state for advice.

Comments

  1. If people remain legally married but live apart, leading separate lives, can a person remain insured on the their spouse’s employee health benefits?

  2. Marriage sucks and divorce is worse

  3. If you ex spouse chooses to continue to carry insurance on you and your child and it is not court ordered but by his choice. Can the insurance company come back on you once he chooses to remove you from the policy by sending in divorce papers?

    • If he pays the premiums on a policy that covers you, then I don’t know why the insurance company would have a problem with that.

      • Lynda Cryer says:

        All of this pertains to current actively working couples. While we were actively working MY insurance, through Verizon, was used because of the ‘birthday’ rules insurance companies have in place. Meanwhile he saved up for our retirement insurance. Now that we are retired he has decided to separate, not really divorce as of yet. Since this is prepaid insurance for retirees will I have to lose said insurance? Seems like his insurance company would make out the best on this all around since they never covered me while we were actively working, nor did they cover him during that time due to the ‘birthday’ rule. Are the rules different for retirement, prepaid insurance? Frankly I feel a law suit coming on since all of the funds paying ahead for the insurance was done while we were together and thus makes it an ASSET under the law. Am I wrong?

        • Oh what a complicated question! There are two places to start: the prepaid insurance plan itself is the first place you should go, to see what it says about divorces and divorced spouses. And then, armed with that information, visit a family law attorney to see whether this is an asset and how you can be treated fairly in all of this.

  4. I am looking into divorce after 25 years of marriage.

    I have no animosity towards my wife and I want to make sure she is taken care of. Her income potential is much lower than mine, so I will have to pay her alimony which is fair.

    However, I don’t know how to take care of her health insurance other than buying for her. If I continue to pay for her through my employer, can she stay on my insurance, or does it have to be done through COBRA?

    • Your wife may stay on your health insurance at work, as long as she is your wife. But employer health insurance doesn’t cover unrelated parties, such as ex-spouses. If your firm is large, she can continue on the insurance under COBRA, but the premiums may be greater than getting a policy of her own.

    • NC Resident says:

      Will, I believe the answer is ‘it depends’. Some employers remove a separated spouse from the health plan (which menas she would have to go on COBRA) and some do not. To know for sure, you have to call them and ask, which to me seems like you are tipping your hand that you are either separated or divorced. I have asked my attorney this very question last week and am waiting to hear back. UGH! Good luck

  5. NC Resident says:

    Ginita, Just to comment on your post… it would seem to me that since a legal separation is NOT a divorce and the two parties ARE STILL legally married, that a company could not remove a separated spouse from a health plan. After all, what IF they reconcile?? And your point is right – she still IS a wife prior to divorce. Do you have any insight on how an employer can do this… I am in the middle of a divorce after 24 years and need to STAY on my husbands policy for as long as possible. We were going to just stay separated but then I started reading where companies are doing this now (removing separated spouses). Just wondering HOW they can do this legally??

    • A legal separation is the same as a divorce in all respects, except that the spouses are not free to remarry. Since financial and legal ties are severed, the employer is not under any mandate to cover the non-employee spouse. If the Affordable Health Care Act doesn’t give you any relief, then you should probably stay separated but don’t go through a legal separation or divorce.

  6. cali divorce says:

    I have COBRA insurance which started when my spouse bifurcated the marital status only to remarry. COBRA started in 2011 the divorce is not final as spouse is hiding assets, drawing it out etc. So, this means that there will be no settlement or trial when the COBRA express. Under law spouse is to continue insurance until divorce is settled and to maintain coverage so I am not “harmed” . what are the options after COBRA expires for this type of situation? Do I find a policy that is equal to my coverage, go to court and spouse pays that? Do I contact the current provider rep who seems nice and is accessible via email and ask what the available options are? my attorney says that we will need to go court to keep coverage etc and status quo but I need to know what route to take on the insurance end, something the attorney is not an expert in. Any suggestions?

    • Generally you can continue the same coverage after COBRA, or switch to coverage under the Affordable Care Act. You can certainly contact the current provider representative about what the current coverage would cost, and you can go to your state’s covered care website after Oct 1 to see what the cost would be of comparable insurance under your state’s plan.

  7. If my son and I are covered under my husband’s insurance and we get a divorce will my son still be able to be covered even if he is a stepchild?

    • He can continue to be covered if he falls under the definition of a dependent child in the insurance plan. Generally that would be natural or adopted children or children by marriage (which he wouldn’t be after the divorce unless he has been adopted by your husband).

  8. Tam Nguyen says:

    I’m 26 years old. I have kidney failure 2 years and I just got kidney transplant 3 months ago. My question is can i mantain insured on my husband’s employee health insurance after divorcing? Our insurance is United Healthcare. He works for that company 5 years. I really need a good and cheap insurance for my health situation. If i can’t keep this insurance, would you know any health insurance which is from government issue for kidney patient? I used to have medicare for kidney patient. And I had to paid almost 100 bucks a month for nothing cause it was a secondary insurance and It just cover only 2 years after transplant. So, I already cancelled it after 1 year paying for it because i thought i had on waiting list for kidney at least 5 years. That means I waste a lot of money for nothing while I had primary insurance from my husband.
    If anyone know anything for my situation, please please please help me!
    Thank you so much,

    • You cannot stay on your spouse’s insurance after the divorce is final. You and he could agree to delay the final divorce, dividing up everything and filing the papers but asking that your marital status not be terminated, so you are still technically his wife and eligible to be on his insurance as such. Or you can check out the Obamacare costs at the health insurance website for your state or the federal government, to see if you qualify for subsidized insurance under the Affordable Health Care Act.

  9. My husband and i have been separated and living separate lives since June. I havent been working in over a year. He moved us to a small town before we separate and i havent had any luck in finding a job. He recently let me know that since we are no longer living under the same house, he is now going to take me out of his health insurance. Can he do this if im not working and we’re still married?

    • The laws of each state are different, but in most states he has a duty to keep you on existing health care plans until the divorce is final. But check with an attorney in your locale to find out the answers to your legal questions.

  10. Does health insurance typically end the day the divorce is final?

  11. I am in Virginia. My wife moved out in 2011 to North Carolina and we have been unable to reconcile. We have finally decided that it’s best if we seperate. I have never been able to afford to adopt my step-children but have accepted them as mine in my heart. My son is 21 and my daughter is ten. Since we are still married on paper I can keep everyone on insurance including my son. I want to continue to keep the kids on insurance after divorce. Is my only option to somehow come up with the money for adoption, even for my 21yo son? Step-child adoption is ridiculously expensive and employer adoption reimbursement does not include step-children, which I think is short-sighted and stupid.

    Thank you,
    Eric

  12. I have been married for 11 yrs. and separated for about 6 yrs. however not legally. I have Multiple Sclerosis. My husband has me under his health insurance. My question is can he be legally responsible to pay Cobra. In my divorce can I legally ask him to continue paying my health insurance or Cobras premium. I currently unemployed.

  13. my ? is, me & spouse are separated and looking to possibly divorce .. if we do go thru with divorce, can spouse still maintain group term life insurance coverage from work on me ?

  14. MIKE IN LA says:

    I live in Louisiana, and I am getting a divorce after 15 years of marriage. She has moved to WY, and I am in the open enrollment process at my work. We have not gone to court yet, but I am ready to take her off of my insurance for financial purposes. My son lives with me and I will continue to ensure that he is insured. By law, do I have to maintain insurance on her?

  15. My parents are divorcing after 41 yrs of marriage, my mother is currently covered under my dad’s retirement package for medical coverage only. She also has Medicare, which I believe is primary and Cigna secondary. Can my mother get secondary coverage from any health insurer? or should she even bother because of the costs at her age? (79) She’s under the impression that she needs to sign up for obamacarfe before the deadline. Please advise.

  16. I divorced in 2011. The papers say my ex husband was responsible for insurance for our children. I pay child support to him as my income is greater. He switched jobs earlier this year and the insurance premium would have risen considerably. We neglected to check the divorce papers and I elected coverage for the children on my plan, instead. We have just realized the mistake and are wondering what to do. My ex can’t put the children back in his plan now because his open enrollment has ended. My insurance company may deny claims because the decree said he was to carry the insurance. Not sure what to do!?! We certainly don’t want to lose coverage for our children.

    • Where did you get the information that your insurance company may deny claims for coverage of your dependent children? They qualify as your dependents, you pay the premiums, so I don’t see how that can be. You can continue as things are now and do nothing, change the agreement to reflect that the coverage has moved to you, or have him insure them at next open enrollment.

      • The insurance company is asking for a copy of the divorce decree. It shows the divorce date as being almost 2 years prior to the qualifying change. It also states insurance should be covered by the father. Hearing horror stories about insurance companies, we are just afraid this may give them grounds to deny claims, or not allow me (the mother) to carry the insurance for our children.

        What would be needed to change the agreement to state either parent may carry the children on their insurance? Just file some document with the court? Any idea what document that would be?

        Thanks for your help Ginita. It is really appreciated!

  17. My mother in-law is staying married to her convicted sex offender husband just so he can have health insurance. They do not speak, live together, or anything else that a real married couple would do. Once again they are only doing this just to keep him covered. I suppose my question is, is this considered fraud ? How much trouble would this cause for her with her employer, law enforcement, and her insurance company?

    • As long as they are legally married, he is still her spouse and eligible to be covered as such under the employer health insurance program. I doubt that law enforcement would require a sex offender to divorce, so I can’t imagine that there is anything illegal in them continuing to be married.

  18. Hello. My ex-husband currently has health insurance for the kids through his work, but he lives out of state and the children live with me. My question is are the kids still covered even though they don’t live in the same state as he does? Thanks for any insight you could give.

    • If the health insurance plan only covers visits to local medical facilities, then the coverage wouldn’t be effective for your family. But that is rare — read the literature provided for the insurance plan to see what the coverage is.

  19. I have been divorced for 6 months, and found out this week, quite by accident, that my ex’s company is changing insurance companies on Jan.1. I was not informed and when I called his company, their in-house expert said she had no information regarding the new carrier! I find it hard to believe that she knew nothing 10 days before such a huge change so I wondered whose responsibility it is to keep me informed about things like this? I do not have a civil relationship with my ex and if I hadn’t found out on my own, I would have just written the check for the cancelled company and been what, uninsured?

    • If you are covered under the COBRA provisions that extend insurance to you for up to three years as a divorced spouse, you have an independent relationship with the insurance company and employer, and it is up to them to keep you informed, not your ex-husband’s responsibility.

      • Janet, If you are covered by COBRA under your ex-husband’s plan, as Ginita said, the carrier and the employer are required to notify COBRA participants of any changes to the policy. January 1 is the usual open enrollment effective date, so the changes are probably occurring now and continue to work through the employer. If your ex’s company has less than 50 employees, the new healthcare law caused major increases in premiums for many. They got temporary relief from this at the last minute, so it is quite possible that he company representative is still trying to figure things out.

  20. I was divorced a year ago and one of my requirements is to maintain medical insurance for my spouse.

    I know she has a low income and would qualify for a subsidy under the Affordable Care Act. But since I pay for the entire premium I am not sure that she would qualify for a subsidy under this scenario. Like everyone else, I would like to see if I can lower my premium payments for her insurance. Is there a way to make this work under the healthcare law?

    And to answer some of the questions above, my ex went COBRA for a while which was $628 per month. The same plan under a personal plan is $378. So we went COBRA until we knew she would qualify for an individual plan. Now with the Affordable Healthcare Act, there may also be tax subsidies to take advantage of.

  21. My husband filed for divorce on Oct. 2nd, the case is still pending. I have had health insurance coverage through him (he works at a company with more than 50 employees). Unfortunately, instead of waiting until the divorce is final to notify his insurance company, he informed me he made changes during his company’s open enrollment period resulting in the termination of my coverage effective January 1st, 2014. As he resides in the state of Ohio, this is in violation of Ohio law (Ohio Revised Code 3105.71). After being informed of his “mistake” he agreed to pay for three months of coverage for me (or for as long as the court specifies), but I am unsure how to proceed.

    I submitted an application through Healthcare.gov and have been deemed possibly eligible for Medicaid, so it does not appear I can simply sign up for some plan for three months (I was informed by his lawyer to pick a plan through Healthcare.gov). As I have several autoimmune diseases and various other serious health conditions, going without coverage for any period of time has serious repercussions. Even with all my medications, functioning is a daily struggle – I am in constant pain, often have difficulty walking, various cognitive issues, etc. Due to various circumstances – timing of refills, DEA quantity limitations for pharmacies, etc. – I will shortly be out of most of my medications, and can not afford to fill them out of pocket.

    I am self-employed, due to my health issues I am barely making any money (and my situation will get worse as I run out of medications) and can not afford to retain a lawyer. I live in a different state which makes things even more complicated. I can not afford to go to the scheduled hearing in January, have already spoken to various legal aid places in Ohio, but my case has not been accepted (without seeing me in person, it is hard to understand the extent to which my health issues affect me). I am afraid I will be forced to “accept” whatever he decides as I do not see any way to “fight” for my rights. I should note, all I want is health care coverage until the divorce is final – as would have been the case had he not terminated my insurance illegally.

    I have contacted the health insurance company and am waiting for a response from them, but would very much appreciate any advice on how to handle this situation.

  22. CRLB NC Resident says:

    I’m going thru a separation that is getting real ugly real fast. I actually do not want to be on my wife’s insurance they provide her as the spousal surcharge is ridiculous. If i agree and she gives me 30 day notice can she have me removed from the insurance without me getting my own insurance? the insurance my jon provides me it’s just as bad if not worse so I do not want it either and I’m fine with paying the first year penalty for “obamacare” what can I do?

    • In many states it is not legal to remove a spouse from medical insurance without that spouse’s consent during divorce. I don’t know the laws of your state, so you’ll need to ask your attorney that question.

  23. The CFO of my husbands company said the company would continue to insure me after the divorce. Is this something the company can do? Would the insurance company allow an ex wife to stay on a company policy. It’s BCBS. We live in Ga, but he works in Ma.

  24. Hey Ginita! Thanks for taking the time to respond to everyone! My father is retired and mother is covered under his medical. Since he is retired, does COBRA still act as an option for my mother after divorce? They’ve been married for 37+ years, is he required to pay anything towards her medical after divorce? Thank you!!!!!

    • The COBRA benefits that your dad has should extend to your mom, even in divorce. I don’t know what the laws of your state provide for payment of medical costs after divorce. In most states, each party is responsible for their own expenses after divorce.

  25. I have a question for a friend who is going through divorce. His wife covered him for health insurance until January of this year. When she re-enrolled at open enrollment last fall she dropped him and just kept the kids on. The divorce is not final and papers were not filed until about a month ago. He did not have a job at the time and just started being covered by a new job’s insurance plan this week. I think she should have had to continue coverage on him until the divorce is final or is that just a human thing to do instead of a legal obligation? He is considering going after back insurance pay since his new insurance does not cover some items that were previously covered under her plan. I know I covered my wife for 30 days after my divorce was final when she had to convert to her own plan.

  26. My wife and I live in California. We recently got a legal separation in August of 2013. She was diagnosed with stage 4 lung cancer 3 months later. Our provider is Blue Cross Anthem prudent buyer plan PPO through my employer. They have been covering the bills but just sent a letter that they are doing an audit to determine if she is still covered as a spouse under my plan. I’m very afraid they are going remove her even though we are still legally married. Can they do this and if so, what are her alternatives? Can we file papers with the court saying we have reconciled? Would that help?
    I appreciate your help so much.

    • I’m so sorry to hear about your troubles. Look at your plan to see if legal separation terminates coverage. If it does, then the only way to resume coverage for her would be as your spouse, so you would have to remarry. You may want to go to http://www.coveredca.org to see what health insurance would cost in the marketplace before you decide to take such a step.

      • Ginita,
        Thank you for your prompt reply. I looked at our insurance plan and it says a spouse is not covered under a legal separation. But under my union benefits trust plan which oversees our health plans, only a divorce is listed as a cause for spousal termination. I’m wondering, since we are still married, but legally separated, if we reconciled, would the insurer still have to cover my wife? Or, once they found out that they were paying while we were legally separated would cause them to deny her in the future because of her medical condition. I appreciate any knowledge you might have.
        Thanks,
        Hugh

  27. A.Rivera says:

    I am in the process of getting a divorce & i have dental and vision coverage through my soon to be ex husband and he took me off already and our divorce just started… Legally.. am I eligible to be covered until the end of our divorce?

  28. M. Solomon says:

    I have just notified my ex-spouse’s employer that we are divorced and I also faxed over a copy of the divorce decree effective March 9, 2014. I am going to apply for COBRA as soon as the application documents arrive in the mail. They do not use email. I have been told that I was removed from my ex’s insurance policy as of March 9, 2014. What concerns me is the interim time between the change. Fortunately, I am healthy but I am concerned if a health situation should arise. I was told once the COBRA application is received it would be retroactive to March 9th. If I were to visit a doctor next week do I have to pay out of pocket and then get reimbursed? If I need to refill a prescription does the same thing apply? In effect, I am without insurance until the paperwork is received by the employer (in this case COBRA is outsourced to another company)?

    • Call the medical facilities and explain the situation, to see what they can do. Many will bill you, and then you can supply the insurance information when you get it. The pharmacy will probably need to be paid at the time you pick up the Rx, but ask them if the insurance discount can be retroactively applied and you can get a refund once your insurance comes through. For those of you out there who plan to get COBRA coverage, be sure to get the paperwork in place before the divorce is final so this doesn’t happen to you.

  29. allen weakland says:

    Irrespective of the laws that govern ex-spouses’ not being allowed to have medical coverage on their spouses’ health plan, if the spouse does not inform the health plan of the divorce, do the insurance companies have ways of discovering that they were divorced? I have an ex-spouse who haunts me for “cruelty” for informing my insurer, saying if I hadn’t, she would still be covered!

    • You are required to advise the insurance company of a change in your status, and they are required to provide information regarding COBRA extended coverage to your spouse. Generally she would find it less expensive to obtain her own insurance in the marketplace rather than through COBRA. The worst possible outcome would be that you didn’t inform your employer, she became ill or was in an accident, and at that time the insurance company discovers the fraud (yes, fraud) and refuses to make any payments.

  30. Maleluca says:

    Are there general regulations or policies on maintaining health coverage in case of divorce. Specifically regarding cases when you are the dependent on the health insurance and not the primary plan participant?
    Can the primary health ins. member decide to maintain former spouse on health plan if he choose to do so? Can this specific provision be part of a divorcee agreement ?

    Are there specific regulations that apply to such matter when the health insurance is a PPO and not an HMO, and the wife and husband live in 2 different States?
    Do health insurances companies have the arbitrary or discretionary power to terminate benefits in case of divorce? Is there a state or federal legislation to clarify one’s rights to health benefits from former spouses?

    • If you are a spouse or dependent child, the employee can maintain you on the policy. After a divorce, you are not covered, since it isn’t allowed by the plan. Insurance companies don’t have arbitrary discretion, they must follow the plan. The federal COBRA legislation gives spouses the right to purchase insurance for three years from the plan in the case of large employers, but generally insurance in the marketplace is a less expensive option.

Trackbacks

  1. […] the marks of being a good prepper is being prepared for the inevitable. Once the divorce is final, the divorced spouse is unable to be on the ex-spouse’s health insurance plan. That being said, there are a few things you can do to make the transition to alternative insurance […]

  2. […] the marks of being a good prepper is being prepared for the inevitable. Once the divorce is final, the divorced spouse is unable to be on the ex-spouse’s health insurance plan. That being said, there are a few things you can do to make the transition to alternative insurance […]

  3. […] the marks of being a good prepper is being prepared for the inevitable. Once the divorce is final, the divorced spouse is unable to be on the ex-spouse’s health insurance plan. That being said, there are a few things you can do to make the transition to alternative insurance […]

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