Unless you and your spouse each have health insurance through your own jobs—and you don't have children—a necessary part of your divorce will be to decide how you'll manage health insurance coverage after the end of your marriage. Many families in the United States are covered by a policy provided by one spouse's employer. Divorce upends this arrangement, because the employer-provided plan will no longer cover the employee's ex-spouse.
Here's what you need to know in order to start the conversation with your soon-to-be-ex regarding health insurance coverage for yourself and the rest of your family once your divorce is final.
The vast majority of employer-sponsored health insurance plans won't cover ex-spouses. So if you're getting divorced and have health insurance through your spouse's job, you'll almost always need to find new coverage.
There are some outlier plans that will allow employees to extend coverage for ex-spouses for an additional fee. Check with your plan administrator to find out if this is an option—and if so, how much it will cost. In many cases, the additional fee might be so high that it makes more sense to just find a different health insurance provider.
In most states, courts automatically issue temporary orders (sometimes called "temporary injunctions") whenever someone files for divorce. Among other things, these orders prohibit the spouses from canceling, modifying, terminating, or allowing to lapse any insurance policies—including health insurance—until the divorce is final.
If courts in your state don't automatically enter orders like this, you can request the judge to issue one.
Divorce won't affect your coverage if you're the primary insurance holder through your employer. But if your spouse is on your plan, you'll need to follow the procedures for notifying the plan of the divorce. Review the plan documents for instructions on how to do this. Most group plans (including employer-sponsored and private plans) will require you to notify the plan administrator within 60 days after the divorce is final.
If you don't notify the insurer on time, your policy could be canceled.
Because health insurance is such a major expense for most families, it's absolutely necessary to determine how you'll handle it after your divorce.
If you and your spouse are working on a divorce settlement agreement, you should definitely address the issue of health insurance. Couples often agree that one of them—typically the spouse who had coverage through work—will pay for the other's coverage for a certain amount of time after the divorce. Another common arrangement is for one spouse to pay the other a lump sum that will be enough to pay for health insurance for a period of time.
Remember that most employer-provided plans won't allow continued coverage for an ex-spouse, so don't agree to this option unless you're positive that it's allowed. You might be able to stay on the same plan under COBRA (discussed below), but that's different from having your spouse's employer continue to subsidize some of your coverage.
If you have a child, the judge will have to review and approve any agreement you've reached about paying health insurance for your child. In many states, health insurance coverage for a child is considered part of a parent's obligation to pay child support (more on that below).
Divorce is considered a "qualifying life event," meaning that it makes you eligible to enroll in a new insurance plan during a special enrollment period (SEP). The length of SEPs depends on the type of plan you're signing up for. Be sure to check the SEP length as soon as possible so you don't miss a deadline.
Common options for post-divorce health insurance coverage include:
Most of the time, divorce won't affect dependent children's eligibility to remain on their parents' plan. Children can remain on a parent's plan even if they don't live with that parent.
In most states, a divorce decree or child support order must include details about how the parents will continue to provide health insurance for their children, as well as how they'll allocate the cost of coverage. Parents may agree about how they'll handle insurance for their children, but a judge will need to approve their agreement. If the parents can't agree, a judge will decide for them.
Some states offer couples the option of legal separation instead of divorce. Many couples choose this option so that both of them can stay on one spouse's employer-provided health insurance plan. But beware: Before deciding on a legal separation for this reason, you'll want to check both your state's laws and the fine print of the insurance plan you're hoping to keep. Many health insurance plans view legal separation the same as divorce, which means they'll refuse to cover the nonemployee-spouse.
If you're working with an attorney to finalize your divorce, your lawyer will help you negotiate post-divorce health insurance coverage. A divorce mediator might also be able to suggest options and help you draft a divorce settlement agreement that deals with the insurance issue.
One of the best online resources for navigating health insurance will be the website for your state's health insurance Marketplace. HealthCare.gov also has a wealth of information about ACA plans as well as other types of insurance. You can also check out your state's insurance commissioner's website for information about health insurance rules and availability in your state.
For information about COBRA coverage, you can visit the U.S. Department of Labor's website.