What Are Your Options for Health Insurance After a Divorce?

Divorce is stressful — and even in simple ones, there may be complicated issues to sort out. Figuring out how you will access health insurance for yourself and who pays for coverage for your children should be considered in your divorce negotiations.

Finding new coverage may seem daunting, but you have options. Take the time to consider the costs and benefits of your choices to smooth your pathway into this new phase of your life.

What health insurance options does the spouse losing coverage have after divorce?

Common options for health insurance after divorce are:

• Your employer’s health plan

• COBRA, which is short for the Consolidated Omnibus Budget Reconciliation Act

• Affordable Care Act (ACA) marketplace

• Medicaid

• Medicare 

There are some circumstances in which you may opt for these lesser-known choices:

• Catastrophic health plan, if you are under 30 or can’t afford health insurance

• Short-term, limited duration insurance

• Medical cost-sharing plan, also known as a healthcare ministry, but be cautious because this arrangement is not insurance and doesn’t have the same protections as health insurance

Do I have to report my divorce to my health insurance company?

Yes. As the covered employee in a group health insurance plan, you need to report the divorce to your plan administrator within 60 days of the divorce judgment date. Your plan administrator must report this information to the health insurance plan administrator.

If you obtained your insurance through the ACA marketplace, you need to report a change in your household or marital status. You can’t make the change by mail, but you can report the change:

• By phone with your health plan or by calling the ACA marketplace call center at 1-800-318-2596

• In person

• Online

How does divorce affect health insurance?

Divorce affects your health insurance differently depending on your family structure.

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For spouses without children who share coverage

During the process of divorce, health insurance needs to remain in place for both parties. As of the date of a divorce judgment, coverage for one of the spouses ends if they were on a shared plan. That spouse will need to secure individual coverage.

One option is to continue coverage from the ex-spouse’s plan through the federal law known as COBRA, which lets people who risk losing health insurance because of certain circumstances, such as divorce or job loss, continue receiving the same coverage for at least 18 months. The law applies to employers with at least 20 workers. Most states have “mini-COBRA” laws that apply to companies with 19 or fewer employees; and some states, such as California, offer COBRA coverage for longer than 18 months.

COBRA premiums can be costly, because you will pay the full price — which includes what the employer was paying toward your insurance premium. Yet, COBRA lets you keep the same healthcare professionals and benefits, and it is sometimes worth the price.

Because a divorce affects your income, you may qualify for government health plans or help. For instance, with a lower household income, you may be able to get a subsidized plan on the ACA marketplace. When you apply through the marketplace, you may find that you’re eligible for Medicaid. Or, you may be eligible for Medicare.

For spouses with children on a family plan

Health insurance needs to stay in place until the divorce is finalized by a court. This is especially true for families with children. The children will generally keep the same coverage they had during the marriage. The spouse leaving the plan may need to find individual coverage.

It’s important to note that children leaving a health plan because of divorce also qualify for COBRA.

If the spouse exiting the health plan chooses to get family coverage, too, that coverage would act as secondary insurance for the children.

In most cases, premiums will change after divorce — both for the spouse who continues with the family health plan and the spouse leaving the insurance coverage. Premiums for the spouse who carried the family’s insurance may decrease when the ex-spouse leaves the plan or if one or more children are no longer covered.

Is divorce considered a qualifying life event for a special enrollment period?

Yes. Divorce is a qualifying life event for a health insurance special enrollment period. This means that you can enroll in new coverage outside your plan’s open enrollment period based on this life change. Otherwise, you would have had to wait until the open enrollment period for either marketplace benefits or your employer health benefits.

ACA marketplace open enrollment typically begins November 1 and runs through December 15 for coverage starting January 1. Some states have extended the sign-up deadline through January. Many employer open enrollment periods happen at some point from October through December, and they typically last for a week or two.

What steps should the spouse leaving the health insurance plan take?

These are the steps you should take if you are being removed from your ex-spouse or partner’s insurance:

1. Research the costs and benefits of your health insurance options as early in the process as possible. Before the court finalizes your divorce, take time to plan where and when you will find coverage.

2. If you opt to use COBRA after divorce to continue your coverage, notify your ex-spouse’s company benefits department within 60 days of your divorce judgment — but preferably sooner — and begin paying your premiums.

3. Make sure that the new health plan is in your name and correspondence is directed to your current address.

Can my ex and I negotiate health insurance as part of the divorce settlement?

Yes. You can, and should, consider health insurance during divorce negotiations. The settlement may include a stipulation that the spouse losing coverage receives enough resources to pay their own health insurance premiums. Planning is important to help prevent family members from ending up uninsured.

Can I keep my ex on my health insurance plan after divorce?

Not usually. In almost all cases, you cannot keep an ex-spouse on your health insurance plan after divorce, because they are no longer a family member.

Some states allow you to have a limited divorce or a legal separation that allows one spouse to keep the other covered on a health insurance plan. State laws vary, and health insurance companies may consider legally separated spouses as divorced for coverage purposes. Check with an attorney in your state to find out how a legal separation or divorce will affect your health insurance coverage.

For families with children, how do you negotiate which parent includes the kids on their health insurance plan after divorce?

In many cases, children can stay on the same health insurance plan that has covered them during the marriage. If each spouse has a separate employer plan, the other spouse can elect a family plan that includes primary coverage for the children or secondary insurance for the children if they also remain on the other spouse’s plan. Coverage on two health plans can be costly and complicated, so you’ll want to consult an attorney. Some families may choose to have the children covered on two plans for reasons including:

• Access to certain healthcare professionals and facilities for continuity of care

• Health needs that would result in lower out-of-pocket costs with primary and secondary payers

• Safety-net coverage if one parent may not have access to health insurance in the near future

Can I keep the same health insurance after divorce?

It depends. For the spouse who would lose coverage due to divorce, federal law gives them the right to continue coverage through COBRA, though they will need to pay the full premium.

The spouse who is the primary insured person or plan subscriber would change their plan to an individual plan if there are no children. Or, if they have children, they would change to a family plan without the ex-spouse or an individual plan if the children will be covered elsewhere.

On the date the divorce is finalized, the spouse who is not the primary subscriber will no longer qualify as a dependent and will not be covered by the plan any longer (unless they elect COBRA).

What happens to our health insurance if my spouse and I are separated but not divorced?

If your state allows for legal separation, many health insurance plans will consider this the same as a divorce and will not cover the spouse. In cases without a legal separation, the insurance remains the same and the plan subscriber cannot remove the spouse from healthcare coverage during the divorce process. If you do remove them, a court will likely require you to reinstate them on your health plan.

Do I have to tell my employer I am getting a divorce?

Yes — if your health insurance is through your employer’s group plan. You will need to inform the person or department that handles health insurance of your divorce. But you may want to wait to notify them until the court’s final judgment of divorce, because some health plans start counting the time limit for COBRA coverage upon notification.

If you’re losing coverage with your spouse’s plan and want to join your employer’s group health plan, you will need to tell your employer. That’s because divorce is a qualifying life event, which allows you to join at any time of year — but you must do so within 60 days of your divorce.

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Written by:

Julia Tell, Ph.D.

Julia Tell is a freelance writer covering healthcare, education, and digital transformation. She holds a Ph.D. in media & communications and has written for publications including Business Insider and EdSurge, as well as nonprofits, international businesses, and educational institutions.

Edited by:

Cindy George, MPH

Cindy George, MPH, is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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