A divorce is more than just the dissolution or termination of a relationship. It also concerns issues of child custody, support, and how assets and debts are divided. One important issue is that of health care. In many marital relationships, one spouse will have medical insurance coverage through an employer that includes the children and the other spouse. So, when the parties divorce, what happens to the medical coverage?

Regarding the children, the insurer for the spouse who has coverage through an employer, or a private or self-insured plan usually will continue to cover the children. The insured spouse can include the cost of covering the children in calculating child support, though the dependent spouse could agree to pay half of the premium and not include it in the child support calculation. But as for the dependent spouse, will he/she also be able to stay on the insured spouse’s plan or be automatically ineligible?

Massachusetts law dictates that eligibility for coverage lasts as long as the spouse is a participant in a group plan. Accordingly, the insurer cannot charge an increased premium merely because the parties are no longer married. In other words, it is as if no judgment of divorce was ever entered. But if the insured spouse remarries, can that individual maintain coverage for the ex-spouse as well as the new spouse?

The ex-spouse is eligible to remain on the group plan, however, the insurer can and will charge an additional premium for family coverage. Unless there is an agreement to the contrary, the ex-spouse will have to pay the additional premium. In this instance, the ex-spouse should examine and compare other medical insurance plans to see if there are less-expensive alternatives. If the dependent spouse remarries, though, the coverage ends. 

State, local, and municipal employees are similarly treated and offered the same protections as those in the private sector.

For self-insured spouses, the law continuing coverage to the dependent spouse does not apply after the divorce. In this case, the insurer is not obligated to continue covering the former, dependent spouse. COBRA coverage is available for the spouse for up to 36-months after the divorce is finalized. COBRA is usually expensive, and most persons will use the time to search for medical coverage options that are more cost-effective but offer the same protections or even more.

When drafting a Separation Agreement, the parties will address the medical insurance issue. A parent whose policy was covering the family will generally continue to cover the children. If each spouse has a separate policy, then it may depend on the type of coverage and the costs as to which spouse will continue the coverage. A divorce lawyer can include a provision in the Separation Agreement that continues coverage for a dependent spouse even if the insured spouse remarries without requiring the former spouse to pay the extra premium either for a certain period or until the dependent spouse remarries. This is an issue to discuss with your divorce lawyer.

Consult Divorce Lawyer Heather M. Ward

Continuing coverage for the children and for the spouses in a divorce is an important issue, and is one of many that a knowledgeable and experienced divorce lawyer like Heather M. Ward can advise you on. Call Boston family law attorney Heather M. Ward at (617) 903-8955 for a free consultation on this and any other family law matter.