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What Happens To Your Health Plan When Your Spouse Is Gone?

Contributor
Heartbreak

Some hints to help you get this off your list and provide you with some peace of mind.

Whether you're in the throes of divorce or you've become recently widowed, the last thing you want to worry about is the status of your health coverage for you and your dependent children. You have a to-do list as long as your arm, plus you're an emotional mess. When it comes to preserving your health insurance, however, it is important that you act quickly.

Here are a few helpful hints that will help you check this big worry off your list and provide you with some greatly needed peace of mind.

Divorce

One giant mistake that people make when settling a divorce is focusing on who gets what--concentrating solely on concrete objects like the house, the car, and the family dog. They neglect to consider the significance of less tangible assets like retirement benefits, life insurance policies, and--you guessed it--health coverage. The following important tidbits of information should prove useful in ensuring that you do not experience any lapse in coverage.

  • Get a Court Order. Many legal professionals recommend obtaining a court order that makes certain that your health insurance premiums continue to be remitted as normal. This should be taken out as soon as your divorce proceedings begin.
  • Negotiating Expenses. Thanks to the Affordable Care Act's marketplace and the ease of using it to comparison-shop, it is now much simpler to determine the costs of health coverage and include it the divorce decree.
  • Coverage for Dependent Children. The Qualified Medical Child Support Order (QMSCO) states that if the non-custodial parent has access to health coverage for their children, they must obtain said coverage. For more information, check out the United States Department of Labor's QMSCO site.
  • Co-pays. Even if your spouse agrees to provide health insurance coverage for your children, you may still be required to pay your fair share of co-pays and expenses that are excluded from the policy. It is important to work out these percentages during your divorce proceedings.
  • "Mature" Divorces. When older couples divorce, it is often difficult for the suddenly uninsured party to obtain health coverage due to "pre-existing" conditions. Thankfully, the Affordable Health Care Act states that health insurance providers are prohibited from denying anyone coverage due to these pre-existing conditions, nor can they charge higher premiums.
  • Waiting for Medicare. Many mature couples are tempted to remain "separated" and officially file for divorce once both parties reach 65--the age at which they become eligible for Medicare. It is important to note that hiding your separation from your employer (and, subsequently, their health insurance provider) constitutes fraud. You may find yourself responsible for paying back every cent that was charged to the plan on behalf of your spouse. For more information regarding eligibility requirements for Medicare, see Getting Started with Medicare.

Death of a Spouse

Losing your life partner is an extremely painful event and you may wish to put some of the tasks involved with settling their affairs on the back burner. Unfortunately, when it comes to health insurance, you have to act quickly.

  • 30-Day Limit. If your spouse had a health insurance plan through their employer, said employer must notify the health insurance provider within thirty days. You will, therefore, have to contact the employer right away.

For more helpful tips, check out How Life Changes Impact Health Insurance.

COBRA

The Consolidated Omnibus Budget Reconciliation Act, otherwise known as "COBRA," can be a life-saver for individuals who find themselves, suddenly, without health insurance coverage. If an employee with a company health insurance plan passes away or becomes divorced, their spouse and children are likely eligible for a subsequent thirty-six months of coverage through COBRA. Before exercising this option, consider the following points.

  • Higher Premiums. Your premiums will be higher due to the fact that your spouse's employer will no longer be paying a share. If your employer offers a plan, it may be less expensive. You may even qualify for a government-subsidized plan or tax credits.
  • Small Companies. If your spouse worked for a company that employed less than twenty people, you may need to look into your state's mini-COBRA coverage. Unfortunately, there are several states that do not have this plan. If you'd like to learn more about each state's individual COBRA plan, check out Understanding COBRA and its Benefits.
  • 60 Day Rule. Most health insurance companies require that you make a decision regarding COBRA within 60 days of them issuing notice. After such time, you will no longer be eligible to opt in.

During a stressful time such as this one, you may feel stretched to capacity. Delegate as many tasks as possible, but be sure to tackle getting your health insurance in order. Your health and your financial security depend on it.

What advice can you offer someone who has recently lost their health insurance coverage?