According to the United States Census Bureau, employment-based insurance was the most common type of health insurance in 2022. Employer health plans often cover employees and their families. So, what happens after a divorce?
If you’ve been covered through your spouse’s employer, you’ll almost certainly have to find new health insurance. Here’s what you need to know about your coverage options during and after your divorce.
Can I Stay on My Spouse’s Insurance During the Divorce?
In many states, courts automatically issue temporary orders (sometimes called “temporary restraining orders” or “temporary injunctions) whenever someone files for divorce. These orders—which are meant to keep the financial status quo during the divorce process—prohibit either spouse from taking certain actions, including changing or canceling health insurance policies.
If you live in a state that doesn’t automatically issue temporary orders, you’ll have to ask a judge to issue one that addresses health insurance (and any other issues that are relevant in your case).
Temporary orders typically last until your divorce is final.
What Are My Health Insurance Options After Divorce?
If you’re on your soon-to-be-ex’s health insurance, you’ll likely have to start looking for new coverage. Very few health plans consider ex-spouses to be “family members” who are eligible for coverage. If you want to stay on your ex’s health plan after your divorce, talk to the plan administrator to see if this is an option.
No matter what time of year you finalize your divorce, you’ll be eligible to enroll in a new insurance plan. Divorce (or loss of coverage due to divorce) is a life change that qualifies you to enroll in or change health plans outside the usual annual enrollment periods.
Here’s a rundown of your potential post-divorce health insurance options.
Get Insurance Through Your Employer
If you’re working, an employer-sponsored health plan might be the easiest and most affordable plan for you. Talk to the plan administrator for details. Most employer-sponsored plans allow you 30 days from the date your divorce is final to enroll.
Stay On Your Ex’s Insurance Through COBRA
You might be eligible to keep your existing health coverage for up to 36 months after your divorce under the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA is a federal program that requires employers with 20 or more employees to allow workers and their families to maintain health coverage after divorce and other qualifying events.
You have 60 days to enroll in COBRA, starting from either the date of your divorce or the date you receive a COBRA election notice, whichever is later. Many people elect COBRA coverage because it allows them to maintain the same insurance while they explore long-term coverage options. But COBRA is expensive. You have to pay the entire monthly premium of the employer plan and an additional 2% administrative fee.
If your spouse works for a smaller employer, you still might be able to extend your existing coverage after divorce. Many states have “mini-COBRA” laws that apply to employers with 19 or fewer employees.
Purchase an Affordable Care Act Plan
You might be able to purchase health insurance under the Affordable Care Act (ACA). The ACA open enrollment period is November 1 to December 15, but you qualify for a 60-day special enrollment period if you lose health insurance coverage through divorce or legal separation.
You can shop for an ACA plan on the “Marketplace.” The Marketplace offers four categories of health insurance—Bronze, Silver, Gold, and Platinum—with varying degrees of coverage, deductible amounts, and premiums. You may qualify for tax credits or extra savings depending on your expected annual income. Health insurance companies can’t refuse to cover you or charge you more because you have a pre-existing condition.
See If You Qualify for Medicaid or Medicare
If your financial situation has changed because of your divorce, you might qualify for Medicaid. Medicaid is a joint federal and state program that offers health coverage to some low-income individuals and families. Medicaid eligibility varies from state to state. You can apply through the Marketplace or contact your state Medicaid agency.
Medicare is a public health insurance program for people 65 or older (or people with certain illnesses and disabilities). Your marital status doesn’t affect your eligibility for Medicare, but it could impact the cost. Learn more about how to get started with Medicare.
What Happens If My Soon-To-Be Ex Is On My Plan?
If you’re the insurance policyholder, you won’t lose coverage when you get a divorce. But you’ll need to notify your insurance plan about your divorce. You’ll typically have 60 days to submit a copy of your divorce decree, but talk to the plan administrator for details.
If you fail to notify the plan about your divorce, you and your ex-spouse will likely be responsible for any overpayment of medical expenses—or your policy might even be canceled.
Can I Negotiate Health Insurance as Part of My Divorce Settlement?
Health insurance is a necessary and major expense for most people. You can and should negotiate health insurance as part of your divorce settlement.
You and your spouse might simply agree that each of you will pay for your own health insurance moving forward. But that doesn’t work in all situations, especially when one spouse has been out of the workforce. In that case, a couple might agree that the policyholder spouse will pay for the other spouse’s coverage for a certain amount of time. Or the spouse who is losing coverage might negotiate for a lump sum payment.
How Will My Divorce Impact My Kids’ Health Insurance?
If you and your spouse have children, your children aren’t at risk of losing insurance coverage because of the divorce. Your children can stay on their other parent’s health insurance plan even if you can’t.
In most states, the cost of health coverage for children is included in the calculation of child support, and the parent who actually pays for that coverage receives a credit. You and your spouse can negotiate this issue, along with the rest of the child support . You'll have to submit your agreement to the court, but judges typically approve these agreements as long as they meet your state's child support guidelines.
Getting Help
You have a lot of important issues to sort out when you’re getting a divorce. Make sure that health insurance is on the list.
If you have questions about how to handle health insurance in your divorce, consider talking to a family law lawyer. If you can’t afford or would prefer not to involve a lawyer in your divorce, a divorce mediator might be able to help you and your ex find common ground on how to deal with post-divorce health insurance.