Is Divorce a Qualifying Life Event for Health Insurance?

If you’re going through a divorce, it will affect your health insurance. Understand the facts to avoid the overwhelming nature of this big life change.

Tara Stombaugh, Director of Consumer Sales and Client Services with Avera Health Plans, offers these facts to make sure you and your family are covered.

Special Enrollment Period After a Divorce

When a couple decides to divorce, they both stay insured on their existing plan during the legal process. Once the divorce is final, the non-policyholder may lose coverage.

When you lose coverage due to a divorce, it triggers a Special Enrollment Period (SEP) under Affordable Care Act approved plans.

“SEPs are protected under the Health Insurance Portability and Accountability Act (HIPAA),” Stombaugh said.

A good first step is seeking health care insurance coverage with your employer, since the SEP makes you eligible. Another idea is to shop for health insurance via the federal Marketplace.

A third choice is to seek coverage through the Consolidated Omnibus Budget Reconciliation Act, or COBRA. This is typically the most expensive option, and you may have special circumstances for going through COBRA, for example, if you are currently in treatment for an injury or illness.

If your situation is complex, be sure to get advice from experts. Speak with your human resources team or the HR provider of your spouse as soon as possible. If needed, do this through your lawyer. Licensed health insurance agents also can answer questions.

Make sure to keep all important documents; your continuing coverage will likely require them.

When Divorce Papers Are Filed, Know Your Rights

Typically in family law, a set of rules, sometimes called automatic temporary restraining orders, prevent either spouse from making changes to things like health insurance. Whether you or your spouse are filing for divorce, neither party can remove the other while the divorce is pending.

If one party tries, they likely will face a penalty.

Many emotions will bubble up during the process of divorce. Remember to take time out and work carefully with your family, friends, HR representatives and other professionals, such as licensed health insurance agents, to avoid mistakes.

Common Questions on Health Insurance and Divorces

Key questions many people who divorce have include:

• Will children be covered? In almost all cases, regardless of the marital relationship, children will remain covered under one of the spouses’ plans.
• Can I stay on my spouse’s plan? Even if you wish to keep your former spouse on your coverage, most employers will not allow you to. However, insurance can be part of a settlement. Talk to your lawyer and a licensed insurance agent to make sure your bases are covered.
• What if I’m separated but not divorced? Check with your insurance agent on this idea. Legal separation isn’t the same as “no longer living together” and until full/final divorce occurs, it’s best to know the facts from the agent or company offering coverage.

“While some answers are straightforward, it’s best to confirm the facts through a licensed agent or your legal representative,” Stombaugh said.

During this process, if you’re considering a health insurance plan through the Marketplace, consider getting an agent. “An agent can look at all the facts and offer approaches that fit your life,” Stombaugh said. “Having that help can provide peace of mind.”

Learn more about Avera Health Plans coverage and benefit options.