Divorce and Insurance- Private Business Employees

Recently we discussed health and dental insurance options for federal employees going through divorce. The reality is, divorce for non-federal employees is a different scenario, as their health insurance policies are governed by different regulations. If you are divorcing and currently insured under your spouse’s health policy, you may be eligible for continued coverage for up to three years through the program COBRA (Consolidated Omnibus Budget Reconciliation Act).

Filling Medical FormWhat is COBRA? COBRA is an act that mandates that employers provide continuation of particular employer-sponsored health benefits to covered individuals, spouses and dependents if they experience a qualifying event that normally prompts a loss of coverage.Through COBRA, the employer is expected to grant “qualified beneficiaries” the option to continue to utilize their health insurance under the plan for 18, 29 or 36 months, contingent on the “qualifying event” that entitles the beneficiary to coverage.

In the event of divorce, you are eligible for continued health coverage under COBRA if your spouse works for a company with 20 employees or more. If your spouse works for a company with fewer employees, you may still be eligible for coverage, but the regulations in this case vary widely from state to state. Either way, you will have to notify your spouse’s health insurance provider within the first 60 days of your divorce’s finalization or they are no longer required to cover you under law.

COBRA begins the day after your active health benefits end. It extends to any benefits you had under your spouse’s plan, including medical, dental, vision, and health care spending accounts. Therefore, if you are covered by a dentist in Cary NC or a dentist and orthodontist in Dublin CA, you may still have these benefits if they existed under your previous coverage.

COBRA is an excellent option for those who are currently unemployed and facing divorce. If you are employed, however, you may decide to switch insurance plans if your own company insurance provider proves to be less expensive. In this event, be sure to investigate which healthcare professionals are covered under this new insurance plan. Perhaps your Northern VA general practitioner might accept your company’s insurance, but your Washington DC allergist does not. Will you be able to find a new, comparable allergist under yourcompany’s health plan?

Understand the stipulations of your spouse’s insurance plan. Insurance plans generally do not cover elective medical procedures. While you may be able to seek skin cancer treatment from a cosmetic surgeon in Northern VA, seeing a dermatologist for Voluma in Washington DC will not likely be covered. Likewise, if your health benefits include dental coverage, your family dentist in Cary NC may be covered but a cosmetic dentist in Dublin CA may not.

Regardless of your scenario, we encourage you to look after your health. The emotional strain of a divorce is difficult enough. Do not let it affect your physical health as well. If it does begin to affect your physical state, see that your healthcare needs are thoroughly covered.

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