Nothing about divorce is easy. If you’ve relied on your spouse for group health insurance through their employer, you’ll need to find new health insurance after your divorce.
You’ll need to move quickly, too. Because the moment your divorce is final, his or her health insurance provider no longer recognizes you as a spouse. If you were to experience a medical emergency, you’d be on the hook to pay for it entirely out of pocket.
Today, we’ll cover how to get health insurance after a divorce. We’ll also explain some key points you should consider when buying individual health insurance. Your first step is to gather any necessary paperwork related to your health. Jot down any prescriptions you take and make a list of any medical devices you need, like oxygen tanks or nebulizers. Then, talk to your employer.
First, Try Getting Health Insurance Through Your Employer
If you’re employed full-time and earning a traditional paycheck, you may be able to get health insurance right after your divorce through your employer. Joining a group health insurance plan at work is almost always the most cost-effective way to find health insurance after a divorce.
No law requires employers to provide health insurance to employees.
But President Obama’s Affordable Care Act (ACA) requires organizations with 50 employees or more to offer group health insurance plans to 95% of their employees. Employers who do not comply must pay a hefty fine (nearly $4,000) for every employee to whom they don’t offer coverage.
- Therefore, if you work full-time, you can probably get a reasonable price on health insurance after your divorce.
- The challenge comes with timing, though.
- Most health insurance providers don’t accept new enrollees every day.
- Instead, they have an annual enrollment period, usually in the fall, for coverage beginning the following year.
- For instance, if you enroll during the fall of 2021, your new coverage will usually start on January 1, 2022.
However, since you’re losing health insurance due to a divorce, you may qualify for a special enrollment period(SEP.) You’ll need to talk to your supervisor or the Human Resources professional at work to find out the details.
But not everyone works full time for a major employer. If you’re unemployed, self-employed or work part-time for a small company, you might be seeking health insurance after a divorce through the government marketplace or private insurers.
The Health Insurance Marketplace vs. Private Insurance
Before the ACA, individuals looking for health insurance after a divorce had to call a few insurers, get quotes, and compare complicated policy benefits and prices. Every insurer offered different plans at different price points. The good news for consumers is that ACA standardized all health insurance plans.
Which Tier Plan Suits Your Needs After A Divorce?
The Metal Tier Levels of Health Insurance are:
- Bronze plans – with a low premium but a high deductible, will cover about 60% of a medical emergency.
- Silver plans – have a slightly higher monthly cost, a somewhat lower deductible and will cover 70% of a medical emergency.
- Gold plans – cost a little more every month, have a low deductible and will cover 80% of a medical emergency.
- Platinum plans – have the highest monthly cost but the lowest deductible and will cover 90% of a medical situation.
Think of these different plans as you would think about gasoline at various gas stations. Unleaded 87 at one gas station will be essentially the same as a gallon of 87 at another gas station.
And a Silver plan from Company A will be nearly the same as a Silver plan from Company B.
Once you choose the right metal tier for your needs, you only need to compare monthly premiums to decide which insurer is offering the best price.
Choosing the Right Metal Tier for Health Insurance After a Divorce
It’s important to think through the metal tiers before choosing a health insurance plan after a divorce. Even if you qualify for a special enrollment period (SEP), once you’re enrolled you won’t be able to change your plan until the next enrollment period.
Now, many new divorcees find themselves short on cash. If this is your situation – you’re single, young and healthy – you might find the Bronze plan suits your immediate financial needs. Just remember that deductibles, prescription drug prices and medical bills will be high if there’s a medical problem in your future.
Silver and Gold plans are often preferred by parents with a tribe of young children and mature adults. You’ll pay more every month for health insurance, but emergency room visits, doctor appointments and medications are more affordable. If you’re responsible for providing health insurance for your kids after the divorce, you might prefer one of these plans.
Platinum plans make the most sense for people with several known health conditions and older adults. You’ll pay a high monthly premium. But you’ll pay less for ongoing doctor visits and numerous prescriptions.
And remember, if you’re nearing age 65 or older, you might be eligible for Medicare after your divorce.
Divorce Triggers SEP for Medicare Eligibility
If you’re 65 – or almost 65 – at the time of your divorce you may qualify for Medicare.
- Medicare is a federal health insurance benefit that Americans earn by paying payroll taxes throughout their career.
- You need to work roughly 40 quarters (ten years) within the last 20 years before retirement to qualify.
Divorce, retirement or other loss of health insurance triggers a special enrollment period (SEP) for Medicare coverage.
Unlike other health insurance plans you might buy after a divorce, Medicare does not have metal tier plans. Medicare Part A is hospital coverage. Part B is more like traditional health insurance. It covers doctors’ appointments and diagnostic tests. Part D is drug coverage, and Part C is usually a combination of Medicare Parts A, B and D.
Part A is the only free benefit. Parts B, C and D will all cost a monthly premium.
Medicare is a complex subject, and that’s an article for another day. Just know that it’s an affordable option for seniors seeking health insurance after divorce.