Can I keep my current spouses’ insurance, what is this going to cost me and can I be denied?
Weekly I receive emails from clients across CA regarding options for Health Insurance.
Fortunately, with the ACA – The Affordable Care Act under the Obama Administration, everyone Qualifies for coverage regardless of their previous or current health condition.
Prior to this Act, 85% of my clients going through a divorce were denied coverage. One of the primary reasons was they had been in counseling to save their marriage. Underwriting required at least 12-months of no therapy visits or medication tied to anxiety or depression.
The following are options to explore:
1. Legal Separation
- Check to see if your spouse’s Employer does not see Legal Separation as a disqualifying event
- While this option is not always available, it is worth exploring if neither of you needs to have the Divorce Final and aren’t looking to remarry
- Pros are that the coverage stays the same and likely will have a lower premium cost because of the Employer’s contributions
- Consolidated Omnibus Budget Reconciliation Act of 1985
- Provides for a guarantee issue of continued medical coverage for the following qualifying events:
- The death of the covered employee
- The termination or reduction of hours of the covered employee’s employment for other than gross misconduct
- Their divorce or legal separation from a covered employee
- Their loss of dependent status by a dependent child
- The covered employee becoming eligible for Medicare
- Federally required for all companies with 20 or greater employees
- COBRA Premium can be no greater than 102% of what it was within the Group
- Coverage can last up to 36 months
- In CA, if the Employer has less than 20 Employees, you are protected through Cal COBRA in the same way as COBRA
- Premium can be 110% of what it was within the Group
3. Your States ACA Exchange
- If your income meets the qualifications, you may receive a subsidy that substantially lowers your premium
- You apply online – here is CA Link
4. Individual Coverage
- If you would not receive a subsidy on the Exchange, applying directly to the Insurance Carrier provides more options
- Working with a Licensed Insurance Broker who represents all Carriers is a good place to start
5. Group Insurance with a new Employer
- If you were the lesser earner or stay at home spouse, this may be something to work towards, since many ERs will pay a portion, if not all of the EEs premiums as a benefit
- Available to all at age 65, if you have contributed via your earned income or your spouse or former spouse contributed. Your spouse/ex-spouse must be at least 62-years old for you to collect on theirs and you would have needed to be married for at least 10-years
- If you have 40-Credits, you can apply online 60-days before the month you turn 65
- There will be a premium for part B (Doctors) and for part D (Prescriptions)
- If there are no earned credits, then a premium would be required for part A (Hospitals)
- If you have been on SSDI (Social Security Disability) for more than 2-years, you are automatically qualified to enroll in Medicare regardless of your age
- Make an appointment with your SS Department 90-days prior to turning 65 to find out what your options are
Finally – Breathe and know you have options.