You’re probably not thinking about health insurance during divorce, but as your lifestyle changes, so will your insurance needs.
There are a few ways that divorce can impact your coverage:
- Your eligibility for certain programs can change
- You might be moving into a different plan service area
- Your budget may be different
- You may not need the same benefits as before
We’ll break it down for you to help make this difficult time a little bit easier.
- How Do I Get Health Insurance After a Divorce?
- Health and Dental Coverage Options After a Divorce
- The Different Health Insurance “Metal” Categories
- Understanding Divorce as a Qualifying Life Event for Health Insurance
- Getting Health Insurance Outside the Open Enrollment Period
- The Cost of Health Insurance After Divorce
- The Best Health Insurance Options of 2020
- Get Help Comparing Different Health Insurance Plans
How Do I Get Health Insurance After A Divorce?
If you’ve been on your spouse’s policy for a while, it can be intimidating to think about all of your options for health insurance after divorce.
Medicare plans are individual only; two people cannot share a Medicare plan. Still, you may want to think about how your budget has changed since getting divorced. Maybe you need a cheaper Medicare Advantage plan now, or maybe you can afford to get some extra coverage!
Things to Know Before Picking A Health Insurance Plan After Divorce
Your spouse’s plan was probably selected with both of you in mind. Now, you can focus on finding the right plan for your needs. Health insurance coverage is truly unique to everyone. An insurance agent can help you figure out which types of health care plans you are eligible for, if you aren’t sure.
You should also know that in some cases, court ordered health insurance after divorce is possible. This may happen in a situation where a spouse wants to put health insurance in a divorce settlement agreement either instead of or in addition to alimony.
If the judge signs off on it, the other spouse may be court-ordered to pay for the other person’s insurance premiums. Alternatively, a court can order one parent to pay for child health insurance after divorce to lift the burden off of the other parent.
Health and Dental Coverage Options After a Divorce
The first thing you should do is figure out what types of plans you’re eligible for.
Here are some plans to consider:
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, was enacted in 1985 to give individuals the right to hold onto their employer’s group health insurance for a limited time after losing it due to a specific event. Qualifying events can include job loss, death, divorce, etc.
To get COBRA insurance after divorce, the 60 day rule applies. You must decide to continue coverage with COBRA within 60 days of your divorce being finalized or you will be ineligible. You should receive a notice with this information in the mail, but you can always contact the plan directly or ask your insurance agent for help.
State Continuation Coverage
State continuation coverage, sometimes called “mini-cobra,” depends on your state. It allows you to retain coverage even if you are not eligible for COBRA. This can happen if your spouse worked for a company with less than 20 employees.
Employer Health Insurance Plan
If you were previously on your spouse’s insurance plan but you are currently employed with a company that offers health insurance, it may be wise to look into your own employer’s plan options first. Getting divorced and losing coverage opens up a special enrollment period for you, so contact your HR department to let them know you are divorced and interested in enrolling in the employer’s plan.
Obamacare Health Plan / Affordable Care Act
If you or your former spouse are not employed and are not eligible for another form of health insurance, the Obamacare marketplace might be the way to go. Keep in mind that getting divorced only qualifies you for an Obamacare special enrollment period if the divorce caused you to lose your current coverage. If you did not have coverage to begin with, you would have to wait for the Obamacare open enrollment period.
Individual private insurance plans come in many forms, but the main types are PPO plans (Preferred Provider Organization) and HMO plans (Health Maintenance Organization). HMOs typically have very small provider networks but are cheaper, while PPOs tend to be a bit pricer but give you the freedom to choose your doctor.
Short-Term Health Insurance
If you know that you’ll be getting a new job with health insurance options soon, or you know that you’ll be qualifying for Medicare soon, you might want to consider an individual short-term plan to hold you over.
Short-term plans usually only last for about three years and are not renewable. They typically do not cover preexisting conditions. For these reasons and more, they can be cheaper than marketplace insurance and are great options for people who are waiting for other coverage to kick in.
If you or your spouse served in the military, you may be eligible for TRICARE health insurance. Divorce is a qualifying life event for changing your TRICARE coverage. If one of you is non-military, that person may lose their TRICARE coverage after divorce. The non-military spouse can keep their TRICARE if they are not remarried, have not purchased other health insurance, and if you were married for at least 20 years and the military spouse had at least 20 years of creditable service while you were married.
Medicaid and Medicare options after a divorce
Your eligibility for social security benefits, Medicaid, and Medicare programs may change after your divorce. Household income and the number of people in your household can make a big difference. Check your state’s Medicaid limits to find out if your divorce allows you to get Medicaid health insurance.
Additionally, while divorce won’t change your Medicare eligibility, it can change whether or not you qualify for Medicare Savings Programs or Low-Income Subsidies for Medicare drug coverage. Plus, if you become eligible for Medicaid, you might also become eligible for a dual Medicare and Medicaid plan.
The Different Health Insurance “Metal” Categories
As you’re looking through your new health insurance policy options, you may notice “metal” categories. Depending on the type of plan, you may be able to choose from bronze, silver, gold, or platinum. This can mean different things for different plans, but they always go in the same order. Bronze is the lowest, then silver, then gold, then platinum.
Different metal categories don’t always affect your medical care, but they usually affect your costs. For example, a bronze plan and a silver plan will probably cover most (if not all) of the same benefits, but a bronze plan will have a lower premium and a higher copayment.
When deciding on which metal category is right for you, think about your budget. As an example, we’ll pretend the bronze option costs $100 per month, and copays are $20 per doctor visit. Meanwhile, the platinum option costs $300 per month, but copays are only $5 per doctor visit. In this case, you may want to make your decision based on how often you visit the doctor.
Estimating Your Health Care Needs
Before you make any decisions about your new healthcare coverage after divorce, think about your medical conditions and needs. Do you take expensive prescription drugs? If so, your first step should be finding a plan that includes great drug benefits. Do you have a chronic condition that requires monthly medical services? If so, you’ll want to check the plans available to make sure they cover the exact services you need.
Consider making a list of all the reasons you normally go to the doctor as well as all the prescriptions you usually take. Write down what you’re currently paying for those items as well as how much you can budget for them. If you meet with an insurance agent, be sure to share that list with them so they can help you find the best coverage.
Understanding Divorce as a Qualifying Life Event for Health Insurance
The first thing you need to find out is, is divorce a qualifying event for health insurance changes in your specific case?
For Obamacare, divorce is a qualifying event to change plans if and only if the divorce forced a change in healthcare. For example, if you were enrolled in your spouse’s plan and are going to be kicked off of it now that your divorce is final, that is considered a qualifying event for getting a new plan. However, if you and your spouse were never on the same plan to begin with, your divorce won’t require you to change coverage, and you won’t be given an enrollment period.
For Medicare, your marital status does not impact your coverage and therefore does not grant you a special enrollment period. However, it can impact other things which can in turn grant you a special enrollment period. For example, if after getting divorced your income drops below the federal poverty line, you may become eligible for Medicaid, which will give you a Medicare Special Enrollment Period.
For Medicaid, if your divorce changes your household income, your Medicaid eligibility may be affected. If you lose your Medicaid eligibility, you will be granted an enrollment period for Obamacare (or Medicare, if you are eligible). If your divorce makes you eligible for Medicaid for the first time, you’ll be able to apply right away.
What if you are separated but not divorced?
Health insurance and separation are not necessarily related. Even legal separation does not require a health insurance change. That means that you will not get a special enrollment period when you separate. If you decide to change your health insurance during separation, you can do so during the open enrollment period (or the Annual Enrollment Period for Medicare), but it is not required.
Getting Health Insurance Outside the Open Enrollment Period
Healthcare providers are required to adhere to the mandated enrollment periods, but you may be eligible to enroll at another time based on a major life event.
When Can I Sign Up for Health Insurance?
The open enrollment period for Obamacare/marketplace plans runs from November 1 to December 15. The Medicare Annual Enrollment Period runs from October 15 through December 7. If you are eligible for an Obamacare special enrollment period, yours will start on the day of your life event (such as your finalized divorce) and will last for 60 days.
How long do I have to get health insurance after divorce?
If your divorce made you eligible for a special enrollment period, you’ll have a short amount of time to enroll in new healthcare coverage. Federal law states that you have 60 days to enroll in COBRA.
The Costs of Health Insurance After Divorce
Was your ex-spouse driving up your health insurance costs? Reduced medical costs due to having one adult on your plan instead of two may allow you to opt for more affordable health insurance.
How much should I pay for health insurance?
Before asking how much you should pay, ask yourself if you’d rather pay higher out of pocket costs or higher premiums. In other words, would you rather pay a large sum every single month and owe very little for your doctor’s appointments, or pay less every month but have high costs when you visit the doctor? You might want to make that decision based on how often you typically visit the doctor as well as how good you are at budgeting.
Financial Questions to Ask When Picking a Health Insurance Plan
Before you pick your plan, ask yourself the following questions:
- How much do I spend each month and each year on medical bills?
- How much can I afford to pay out-of-pocket for emergency or unplanned medical expenses?
- Can I afford to pay a higher premium each month in exchange for more benefits?
- Would a higher deductible or a higher premium be better for my budget?
Tax implications and Healthcare Costs
After getting divorced, don’t forget to include alimony, child support, and other aspects of your settlement agreement when budgeting. Additionally, remember that if your annual medical expenses (including health insurance premiums) totals more than 10% of your annual gross income, you can deduct them from your taxes.
Both spouses can benefit from this in the year following divorce. After that, it’s up to each individual.
The Best Health Insurance Options in 2020
Regardless of your divorce, it’s important to review your health insurance every year to make sure you’re still in the best plan for your needs. Insurance companies can change their plans every year. They can change their network providers, benefits, costs – basically anything. Make sure you read any emails or letters you receive from your insurance carrier in case they’ve made changes.
To find the best health insurance options for you, first decide if you’re looking for Obamacare, Medicare, Medicaid, TRICARE, an employer plan, or something else entirely. Then, make a list of all your favorite doctors and all of the major medical services you need coverage for. If you’re eligible for Medicare, you can use our tool at medicareplanfinder.com to find the best health insurance options for you.
Get Help Comparing Different Health Insurance Plans
We always recommend speaking with an agent to compare different health insurance plans. It doesn’t cost anything for you to meet with a licensed agent. Since they sell plans all day, they’ll be able to tell you the differences between your favorite plans and help you understand what everything means.