Individual Health Insurance and Divorce

One fallout of divorce is that one spouse may have depended on the other’s health insurance coverage, typically through an employer-sponsored plan. Electing health insurance from the individual market can be overwhelming, especially in a heightened emotional state.

First option - Cobra

If your ex-spouse had employer-sponsored coverage, you’re entitled to 18 months of Cobra coverage. Cobra coverage can be more expensive than what is available in the individual market, but it may be the best solution if you have already met your deductible for the year. For Individual coverage, you will have multiple carriers in the marketplace. It is important that before you start researching coverage, you put a list together of all your doctors and prescriptions. The individual carriers have networks that are more narrow than traditional employer-based coverage. Pharmacy coverage will also vary from carrier to carrier. Through the Affordable Care Act, you may be eligible for premium assistance. Premium assistance is determined by household income. If you are just returning to the workforce, your taxable income may be low, which could qualify you for a low-cost policy along with cost-sharing reductions (CSR). CSR can reduce your deductible and out-of-pocket costs significantly. If the father is concerned about his physicians who operate in a different health system, rest assured; we can split the coverage and put Dad on his plan.

Dependent Coverage

If you are required to cover the children, it is essential to be able to claim them as dependents under the IRS. If your children are considered dependents, your premium assistance can be higher.

If your children are not considered dependents, applying for coverage with premium assistance can be challenging. The marketplace will require you to provide your ex’s information, including their household income, which can result in lower premium assistance and even having to pay the assistance back

If you are overwhelmed, step back and reach out to us. We will help you with the options.

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