Divorce and Medical Insurance

Each year you make medical insurance decisions.  You review plan summaries, benefit options and premium costs.   After a lot of time, effort and analysis, you select a plan for the next year.  It’s complicated and when you are in the midst of a divorce — it feels even more complicated.

For some, this is your one and only chance to take advantage of the Massachusetts laws helping families after divorce. Your decisions today may affect family finances for many years to come. What should you do if your spouse is the health insurance subscriber?

Can I stay on the family plan after the divorce?

You may be able to stay on your spouse’s plan.  There are Massachusetts laws requiring insurance companies to provide coverage to an employee’s spouse after the divorce.   If these laws apply to your spouse’s insurance, then you may be able to stay on your family plan after the divorce.  You may be able to continue on the plan until one of you remarries or for so long as the plan is available to your spouse.

Find out if your spouse’s health insurance is covered by one of these Massachusetts laws that require “continuation of coverage” following divorce.  Your spouse can ask his/her employer for this information.  If so, then make sure to ask your collaborative attorney or mediator to include the proper language in your separation agreement to take advantage of these laws.

What does it cost?

If you can stay on your spouse’s medical insurance plan (because of Massachusetts law), then premiums will not increase because you divorced.  If at the time of your divorce, the premiums were $200.00 for both of you, then immediately after the divorce the premiums will be $200.00.

Your next decision is: Who pays the premiums?  Perhaps you may both agree that you should reimburse your spouse for the additional cost for your coverage.  For example, if your spouse would have paid $120.00 for his/her own plan but because you are on the plan, your spouse is paying $200.00  – then you may want to reimburse your spouse for $80.00.    Also, you and your spouse will want to discuss the tax consequences of including you on the policy.

No, I can’t stay on the family plan – now what?

If you discover that the current family plan will not provide coverage to you, then you have other options.  Explore whether there is a medical insurance plan available through your employer.  If so, ask if that plan will provide continuation of coverage for your spouse. Then you can both discuss if you should carry health insurance for the family. If you both agree to use your medical insurance plan, be careful to time enrollment and divorce to take advantage of these laws.

Perhaps you qualify for temporary COBRA benefits.  If you do, then you may have health insurance for up to 1.5 years after the divorce.  Be warned that this option can be expensive.  Finally, remember that you should be able to obtain an individual health insurance policy through the Health Connector.

Timing is important.  Pay attention to open enrollment periods, qualifying events and other factors with specific time requirements.

How do we decide?

As a divorce mediator, I can help you and your spouse discuss this issue and reach a decision that works best for both of you.