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Will I Lose My Health Insurance When I’m Divorced in California?

November 25, 2019 By Kathleen Faulkner

Health Insurance and Divorce

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

2. COBRA

  • Consolidated Omnibus Budget Reconciliation Act of 1985
    • Provides for a guarantee issue of continued medical coverage for the following qualifying events:
  1. The death of the covered employee
  2. The termination or reduction of hours of the covered employee’s employment for other than gross misconduct
  3. Their divorce or legal separation from a covered employee
  4. Their loss of dependent status by a dependent child
  5. 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 
    • https://www.coveredca.com/

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

Medicare

  • 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 
    • https://www.ssa.gov/benefits/medicare/
    • 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.

Want to read more?

How Much Does a Divorce Cost in California?
How Do I Get a Divorce in California?
The 7 Habits of Highly Effective Clients in Divorce

Filed Under: Blog Tagged With: Divorce, Health Insurance

What our clients are saying…

Anonymous Client

I think this is probably true of a lot of marriages that end in divorce: neither one of us felt “heard.” The [collaborative] process was an eye-opener… and an “ear-opener” I guess you’d say.  We each got to say our piece.  And, I can’t speak for my ex, but I felt she “got” what I was talking about in a deep way.  To me, that was what made my divorce really a completion.  When we were done, we were DONE.  And now we’re okay parents together.  I’m not mad at her, she’s not mad at me.  I’m really grateful to [my coach], for showing me the way.

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