Different states have different laws governing continuing health coverage for the spouse who does not carry health insurance for the family unit. Connecticut is on the more restrictive end of the spectrum. In Connecticut, medical insurance coverage for the non-plan-subscribing spouse ends at the Date of Divorce. There are some employers that continue coverage until the end of the month of the divorce, but this is not the norm.
Divorcing spouses have the option to elect COBRA coverage for up to three years from the Date of Divorce. COBRA coverage is a continuation of the medical insurance that the spouse had during the marriage. “COBRA” is the acronym for the Consolidated Omnibus Budget Reconciliation Act of 1985. This Act allows workers and their qualified dependents the right to continue employer-sponsored health insurance for varying periods of time if that insurance stops due to termination of employment, reduction in work hours, or changes within the immediate family such as divorce.
In Connecticut, the maximum COBRA coverage period in a divorce is different than in a loss of employment. In a loss of employment, the maximum COBRA period is eighteen months. Still, a period of three years goes by very quickly, especially when a person is trying to recover from a divorce which often includes re-entry into the job market and significant financial adjustment.
There are disadvantages to COBRA coverage—mainly the cost. COBRA coverage is very expensive. It is often less costly for a divorcing spouse to get his or her own health insurance through a completely different policy or insurer. It is a matter of weighing the available options. Oftentimes, the current medical policy has better terms, including lower deductibles and co-pays. There may also be a more expansive provider network, including out-of-network services. However, the cost of COBRA may not be worth the more favorable provisions of the policy. Each person’s situation is unique, and the variables need to be compared accordingly.
For some divorcing spouses, COBRA coverage is essential. The divorcing spouse may be in the midst of intensive medical treatment, or the individual’s life may be dependent upon care that is available only through the COBRA insurer. In such a case, the three-year COBRA limit is still a problem, but, for at least three years the medical treatment will be available, even if at a large cost. Healthcare policy in the United States is always subject to change, so there may be a “saving grace” program that is offered within the three-year time period to allow the divorcing spouse to maintain the needed coverage beyond the limit.
Young people who are divorcing may feel that medical insurance is not a relevant or important issue for them. That is bad thinking. A person never knows what can happen regarding health in the next minute. The good news for younger people is that COBRA coverage may come at a lower cost as health insurance premiums are usually lower for younger individuals.
Can I Require My Spouse to Pay for My Medical Insurance in the Divorce?
The answer to this question is case-dependent. There are many variables, including, but not limited to: COBRA cost; the need for the specific COBRA coverage; the finances of the parties; the ability of the non-subscribing spouse to acquire new, comparable health coverage; the ability of the non-subscribing spouse to acquire any new health coverage; the division of marital income and property; the ages of the parties; and, the level of flexibility for the non-subscribing spouse to forgo other marital income and/or assets to allow the subscribing spouse to pay for COBRA coverage.
The important thing is to have excellent legal representation in your divorce so the issue of continuing medical coverage is explored and resolved to meet YOUR situation as well as possible.
What about the Affordable Health Care Act, a/k/a “Obamacare?”
The Affordable Care Act, often known as “Obamacare,” was a huge step forward for divorcing couples. Prior to the Act, a person could be penalized regarding medical coverage for pre-existing conditions. If a person had a pre-existing condition, such as cancer, high blood pressure, or diabetes, a medical insurer could deny coverage. This made it impossible for many people seeking divorce to end their marriages. For example, if a person had a pre-existing condition, and the person was not employed or his/her employer did not provide health insurance, their only option was COBRA insurance. COBRA, however, has a three-year limit in Connecticut and is often cost prohibitive. If a person in this situation was 55 years old, three years of COBRA coverage would only get him/her to age 58. Then what? Medicare coverage does not begin until age 65. If the person had sufficiently low income to qualify for HUSKY, that was an option. However, in most cases, there is an element of family support which usually puts a divorcing spouse above the HUSKY qualification limits. For this reason, some people remained married simply to maintain their health insurance coverage.
Health coverage under the Affordable Care Act is much more affordable than COBRA, at least for individuals who are not high-income earners. The premiums are lower than market rates. In Connecticut, the Affordable Care Act premiums are based on income. There is a wide range of available plans, from Bronze to Platinum.
Connecticut’s HUSKY Insurance Program
HUSKY is Connecticut’s income-based health insurance program. There are four HUSKY programs: HUSKY A, HUSKY B, HUSKY C and HUSKY D. Connecticut children, their parents or a relative caregiver, and pregnant women may be eligible for HUSKY A (also known as Medicaid), depending on family income. Uninsured children under age 19 in higher-income households may be eligible for HUSKY B (also known as the Children’s Health Insurance Program). Depending on specific income level, family cost-sharing applies. Connecticut residents age 65 and older, age 18 to 65 and blind, or otherwise disabled, may qualify for Medicaid coverage under HUSKY C. HUSKY D provides health coverage for eligible low-income adults without dependent children.
Both Obamacare and HUSKY are administered by Access Health Connecticut. The phone number for Access Health Connecticut is 1-855-805-4325. It is important that you contact Access Health Connecticut as each case is evaluated on its own factors regarding eligibility.
At McConnell Family Law Group, Our Attorneys are Fully Knowledgeable about Medical Insurance Needs in Divorce. As the old saying goes, “when you have your health, you have your wealth.” Good medical insurance is integral to maintaining good health. Be sure to fully consider this important item in your divorce.