Will I Lose My Health Insurance When We Divorce?

Your health may be the most important asset you have and protecting it is top priority.

Maintaining health insurance is a top priority, and the uncertainty about how coverage will be maintained during separation and after divorce is a very sensitive subject during divorce proceedings. Each spouse is equally concerned and has questions about when the dependent spouse’s coverage will end and who will pay for the coverage until it does.

It is important to seek counsel from an experienced family law attorney to help navigate these changes.

Pennsylvania’s Divorce Code specifically provides that a “court may direct the continued maintenance and beneficiary designations of existing policies insuring the life or health of either party.” In addition to the court directing one spouse to continue health care coverage for the other, it will also address the anticipated unreimbursed medical expenses for the dependent spouse, each child, and the allocation of those costs between the parties.

These issues are expounded upon in Pennsylvania Rule of Civil Procedure 1910.16-6(b-c) which states the premium of the health insurance coverage shall be allocated in accordance with the parties’ net income, as long as a statutory duty of support is owed. This same allocation is applied with regard to determining the percentage that each spouse is responsible to pay for unreimbursed medical expenses involving the children. Said medical expenses include the co-pay and deductibles, as well as any other additional expenses incurred for medical, dental or vision care. The allocation is based upon the net income of each spouse, and comes into play when medical expenses exceed $250 annually, per child.

It is important to note that while Pennsylvania law requires a spouse to maintain health insurance coverage for the dependent spouse during the pendency of a divorce action, once the divorce decree is entered by the court, the dependent spouse will be removed from the health insurance policy provided by the spouse’s employer. This does not necessarily mean that the dependent spouse is left without insurance. An alternative, federally provided benefit may be offered to certain individuals.

The Consolidated Omnibus Budget Reconciliation Act, commonly known as COBRA, allows eligible individuals to continue coverage under the same plan, at their own expense. COBRA permits a divorced spouse to remain on the same health insurance provided by their spouse’s employer for up to 36 months. COBRA may or may not be the best alternative health care coverage for a divorced spouse depending on the spouse’s eligibility, the cost of the plan, and length of coverage required. While the insured spouse’s employer is no longer required to contribute to the dependent spouse’s coverage, in some cases the court may order the insured spouse to be responsible for a portion or all of the cost of the dependent spouse’s coverage.

If you are concerned about maintaining health insurance coverage during and after your divorce, speak to the experienced legal team at Pollock Begg Komar Glasser & Vertz LLC. Call (412) 471-9000 to speak to one of our family law attorneys or use our online contact form

About the Author

Lindsay A. Nemit is an associate attorney at Pollock Begg with a comprehensive family law practice including complex custody and divorce. She is a certified mediator and collaborative law practitioner.