Health insurance can be a major problem in a divorce if your soon to be ex-spouse has been providing family health insurance coverage through his or her employer. Once you are divorced, you are no longer eligible for coverage. Even if your spouse will still be providing health insurance for the children, he or she cannot provide coverage for you through the employer’s group health plan because you’re no longer a member of his or her family. There is no way around this unfortunate reality. If a couple gets divorced, then the other spouse will lose his or her eligibility for group medical insurance coverage.
Once the divorce is final, the only option you, the ex-spouse, may have is to obtain individual health insurance directly from an insurance company. The advantage of an individual policy is that you can shop around for prices and benefits. The disadvantage is that the cost is higher than with a group plan and you have to pay the entire cost of the insurance premiums. Further, if you have a preexisting condition, it may be difficult to obtain any alternative health insurance at an affordable price.
Currently, the cost and availability of individual plans remain unsettled until Congress decides whether there will be any major changes in what is commonly called “Obama Care”. It remains to be seen who will be eligible and at what price. Another possibility is continuing the employer health insurance under COBRA. However, COBRA only coverage lasts for 36 months and you have to pay the full cost. Often the cost of COBRA is more expensive than an individual plan. Your spouse’s employer is required to provide COBRA coverage for you, but only if you notify the health plan administrator within 60 days of becoming divorced. If you don’t give the administrator proper notice, then you will not be eligible for the coverage.
In South Carolina, the parties have to live separate and apart for one full year in order to obtain a no fault divorce. During this period it is common for the South Carolina family court to issue an order of separation and maintenance, either a temporary or final order. The parties still remain legally married until they return to court and obtain an absolute divorce. This means that the spouse can retain coverage on the employer’s group health insurance plan.
With a final order of separation and maintenance, the parties receive a judgment that equitably distributes their assets; sets child and spousal support; and decides child custody and visitation. A final order of separation has all of the same attributes of an absolute divorce, except the parties can’t legally remarry.
The benefit of having a final order of separation is that you can still receive health insurance benefits from the other spouse’s health plan because there is not a complete divorce. This may be a viable option, especially where one party has some type of serious health issue. Retaining health benefits is the primary reason why a couple may choose to obtain a final order of separation rather than proceeding with an absolute divorce. Normally, this requires that the parties remain reasonably civil to one another and that they reach an agreement as to the terms of the final order. This means that you may have to agree to take less in spousal or child support in return for the health care benefits.
At any time after the parties have lived apart for one year, either party can file a petition with the family court for a no fault divorce. A no fault divorce is a full divorce, giving both parties the right to remarry. Of course, if a divorce decree is entered, you will lose your health benefits. Once the family unit is officially terminated by divorce, any employer provided health plan is no longer legally obligated to provide you with health insurance coverage.
An experienced South Carolina divorce lawyer can fully explain to you the pros and cons that final order of separation and maintenance has to offer. However, if a dependent spouse suffers from a severe medical condition, and if maintaining health insurance is a “life or death” issue, then it is worth serious consideration, especially if the spouse will be eligible for Medicare within a reasonable period of time.