It is unlikely the first consideration you have when separating is how your separation will affect your health insurance coverage, but a change in marital status can change your eligibility for benefits. As of July 2020, the average annual cost of health insurance in the US. is $7,470 for an individual and $21,342 for a family, according to the Kaiser Family Foundation. 

Given how costly health care and insurance coverage can be, if you or your spouse have filed for divorce, the impact to your health insurance is one of the things you and your attorney should consider. You have enough going on in your life to navigate – you do not want to find yourself unexpectedly without health insurance coverage which can lead to you incurring highly expensive medical bills.

Most often, when a couple is married, especially with children, they will all be covered under one medical, dental, vision, and/or prescription insurance plan. That is usually the most cost-effective way to insure everyone. After a divorce, many private plans no longer allow an employee to keep an ex-spouse on their health, dental, vision insurance, etc. However, during a separation, even if a divorce is pending in the Court system, the policy most often covers both people because they are still legally married. 

During a separation, a knee jerk reaction can often be to remove an ex-partner from insurance coverage immediately. Tensions run high, and it often seems like an unfair burden to the party carrying the insurance to continue to cover their spouse when are no longer together. However, it is not advisable for the policy holder to change insurance policies or beneficiaries of current policies without confirming with their attorney or the Court they can do so. The Court does not want to leave a party unexpectedly without health insurance. In certain states, if there is a pending divorce, the policy holder can be restricted from the Court from making such a switch. Even when a divorce has not yet been filed, the Courts typically look unfavorably upon such moves. If you are required to continue insurance coverage, you should also make any cards or insurance information your spouse needs reasonably available to them.

It may seem frustrating that you still have the burden of paying for health insurance for a spouse with whom you are no longer in a relationship, but there are many factors that may go into determining whether there will be future responsibility for their health insurance coverage that your attorney and the Court will consider. Some states will factor the amount a party is paying for medical insurance into calculations for child support or as a contribution for spousal support, because they realize it is a financial burden for the policyholder to carry and imparts a real benefit upon the insured. 

How to know if you can be covered after a divorce?

You can generally get the information relative to your plan or your spouse’s plan from the employer’s Human Resources (HR) Representative or Department or from the Plan Administrator of your plan. If a plan does not cover a ex-spouse after the divorce, they will likely need to start looking for alternate insurance coverage. 

Options for coverage upon divorce if you cannot remain on your spouse’s plan: 

1. Your Employer Sponsored Health Care Plan

If you are employed at the time of your divorce, and not eligible to remain on your spouse’s plan, the first suggestion is to look at what benefits your own employment may afford you. A call to your HR Department may help you understand your eligibility. Benefits through your own employment are often the most affordable options of coverage. Like the birth of a child, losing coverage due to a divorce is the grounds for a special enrollment period that could allow you to sign up for your employer’s plan even if it is not during the typical enrollment period. If you are looking for employment at the time of a divorce, and you learn that you may be responsible for your health insurance upon the divorce being finalized, the insurance benefits a potential employer may offer could be a serious consideration to look at relative to your overall compensation package.

2. Affordable Care Act/ Health Care Connector Options

Everyone is now able to obtain health insurance through the Affordable Care Act, or Obamacare. There often is a state exchange website for this health insurance. Just as discussed above with employer options, you have 60 days following your divorce to get coverage during what is known as a Special Enrollment Period. If you miss this period, you will need to wait until the Open Enrollment Period, which happens annually.  

3. COBRA 

The Consolidated Omnibus Budget Reconciliation Act (or COBRA) allows some workers and their families to continue their current group policies in certain circumstances, such as divorce. You may be eligible for COBRA health insurance coverage for a limited amount of time, generally about up to 18 months. There is generally a requirement you apply for COBRA coverage within a short period of time after your plan is terminated (30-60 days), so you do not want to delay investigating this option. Even if you are eligible for COBRA coverage, it can be an expensive option, so you may want to explore whether there are more cost-effective options for coverage.

4. Short-Term Health Insurance

If you miss an enrollment period, or believe you will be obtaining insurance coverage from an employer in the near future, investigating short-term health insurance may be worthwhile. These are usually harder to qualify for, with more restrictions on pre-existing conditions and have limits on how long the length of coverage will be, but if you qualify, they can be a means of putting coverage into place quickly.