Health care is a major issue for anyone who is aging, but for people over 50 who find themselves in the midst of a divorce, health care coverage is front and center. This article addresses strategies for looking at the future and putting together the pieces of the health care puzzle if you're going through (or considering) a late-life divorce.
As soon as you know your marriage is ending, take steps to keep your existing health coverage in place and to look for replacement coverage. If you're concerned that your spouse may drop your employer-provided insurance or fail to pay premiums for your coverage, tell your attorney immediately so that the lawyer can act to assure that your insurance remains in place. If you know that you'll need private health insurance coverage when your divorce is finished, start the process immediately. It takes time to study the different policy options and apply for coverage. (For basic information on health care coverage, see Nolo's article Understanding Your Health Insurance Coverage.)
The least expensive type of health insurance is employer-provided group insurance. If you are covered through your own employment, you're lucky. If you are covered through your spouse's workplace, you may be entitled to COBRA coverage (discussed below). Otherwise, individual insurance is your starting point.
Individual Health Care Plans
There are many varieties of individual health care plans, including:
- expensive plans offering greater coverage
- lower-priced plans limiting hospital and physician access
- plans with no deductibles, no co-pays, no waiting periods
- umbrella plans with many health services (including dental, prescription, and vision)
- preferred provider plans (PPOs)
- HMO plans
- catastrophic plans, and
- mini-med plans (very limited coverage for those with preexisting conditions).
Where To Start. You can purchase individual health insurance through an insurance agent, an insurance company website, or a mass purchasing group such as a credit union, professional or trade association, or an organization like the American Association of Retired Persons (AARP). Consult with agents early so you'll learn terminology and options that will inform your independent search. Compare policies of the same type and offering the same benefits. Otherwise, price differences are meaningless. Here are some key insurance terms to help you choose the right plan:
- Deductibles - a specific amount you must pay before expense reimbursement begins. The higher the deductible, the lower the cost of the plan.
- Co-insurance or co-pay - the percentage split between the individual and the insurer of covered expenses (for example, the insurer pays 80% and the insured pays 20%). The lower the insurer's percentage, the lower the cost of the plan.
- Covered expense - an eligible expense, reimbursed in whole or in part. Some policies allow for payment of a "reasonable and customary charge" -- if the actual charge is higher than that, the insured person must pay the balance.
Cancellation and renewal Coverage. Generally, once you are covered by private insurance, the carrier cannot arbitrarily cancel your health coverage. However, your insurance can be cancelled for:
- failure to pay premiums
- failure to disclose relevant medical information, or
- elimination of benefits
Look for non-cancellable, guaranteed renewable coverage. If you can't find that, try to get a "conditionally renewable" policy; this gives the company the right to cancel all policies in a particular category, but you can't be singled out for cancellation.
1 | 2