As many considerations and worries flood your mind when the process of divorce begins, most of which are practically and financially concerned, you need to be informed of how divorce affects your health policy. If you are a dependent on your spouse’s health insurance plan, you should prepare for the future very soon, especially depending on the type of coverage you have. Laws pertaining to health insurance and divorce are very simple and clear cut: once your divorce is finalized you cannot stay on your ex’s plan.
While the divorce is still in the works, you can keep your coverage as is, so that gives you a slight amount of breathing room. Unless your ex is generous enough to consider convincing the judge to keep you on the plan, you will need another source of coverage. It is essential to apply for your own health insurance plan to eliminate uncertainty and worry in one area, and gain some independence. If you are unable to afford your own policy based on your income, look into Medicaid.
When the divorce process is complete, the non-policyholder spouse is eligible for COBRA coverage if they are under a group plan from their ex’s employer. COBRA lasts for a maximum of 36 months, and rates increase significantly from what you usually pay, so would likely alleviate some financial stress to get an individual plan in lieu of COBRA. COBRA continues the same coverage you receive currently, without the employer paying their portion of the premiums.
If the dependent spouse has a pre-existing condition and cannot qualify for an individual health plan, COBRA or PCIP are decent options. At this point, both of those plans will last about the same duration of time, as PCIP is a temporary high-risk pool. Though not as comprehensive or long-term as an individual health plan, these plans provide benefits if you have a chronic condition or illness that makes you a risk factor for health insurance companies.
Health insurance is a serious factor in divorce, causing many couples to choose a legal separation in order to keep their spouse on the plan. Although it may not be an official divorce, some health insurers consider legal separation on par with divorce, and will discontinue benefits just the same for the dependent spouse. In other cases, it may not affect your health insurance at all and all dependents, spouse and children included, can remain on the same policy.
Maintaining your children’s insurance is also an important consideration in the divorce process. In certain cases, the insured spouse will be required to make sure the child has health coverage. If applicable, most states require the insured individual to continue their child’s coverage until a certain age. These obligations may differ if your spouse had the child before the marriage and you are not the child’s natural parent.
The child support section of the divorce agreement determines who is responsible for providing the children’s health insurance. If the non-custodial parent, their insurance company, or their employer is unwilling to comply, there is a federal law protecting your children’s continuation of health coverage. The Qualified Medical Child Support Order (QMSCO) mandates that parents who have custody are legally able to obtain health insurance for their children through the noncustodial parent’s group health plan, if they have such coverage.
Children cannot be denied access to the plan, though limitations may be imposed. The order will not require the plan to provide additional benefits not offered through the plan. The QMCSO may require the premiums for the policy be taken out of the employee’s paycheck. Reimbursements for care are made directly to the custodial (nonemployee) parent when that parent pays a provider for the child’s care.
The noncustodial parent is unable to select a health plan that is unsuitable for the children, according to the QMCSO. As the custodial parent, you should obtain copies of you ex’s medical plan, claims and election forms, the summary of benefits, and the page indicating those currently covered under the plan.