About 115,000 women nationwide lose private health insurance
every year after divorce, and 65,000 of them become uninsured for
months or even years, according to a recent
University of Michigan study
The study, published in the December 2012 issue of the
Journal of Health and Social Behavior
, analyzed data from 1996 through 2007 on women ages 26 to 64. The
University of Michigan National Poverty Center supported the
"Moderate-income women are more likely to lose coverage than
higher income and low-income women," says lead author Bridget
Lavelle, who conducted the study with UM sociologist Pamela Smock.
"They're earning too much money to qualify for public assistance,
Yet they don't make enough money to afford a new
Women who are dependents on their spouses' employer-sponsored
health plans are particularly at risk. A quarter of them are
uninsured six months after divorce, according to the study.
Those who have their own employer-sponsored coverage are less
likely to lose it after divorce. Still, 11 percent of them become
uninsured. The study didn't examine why those women lost coverage,
but Lavelle speculates they were no longer able to afford their
share of the premium.
Women ages 50 to 64 are more vulnerable to losing health
insurance than younger women.
Health care reform might help
Other studies have shown that women's incomes drop after divorce
and that married people are generally healthier than single people.
But little research has focused on how divorce impacts health
insurance, says Lavelle, a doctoral candidate in public policy and
The study did not look at how divorce affects health insurance
coverage for men, but Lavelle says that's a good question to
address in future research. The impact on men may not be as severe
because women are more likely to be dependents on their spouses'
health plans than men, according to the Kaiser Family Foundation.
And previous research has shown that women suffer greater economic
losses after divorce than men.
Lavelle says she'd also like to see researchers look at the
issue again after health care reform is fully implemented. A number
of important provisions of the Patient Protection and Affordable
Care Act will go into effect in 2014, when almost everyone will be
required to have health insurance. More people will become eligible
for Medicaid, and many lower- to moderate-income people will become
eligible for government subsidies to help them afford health
insurance. In addition, health insurers will no longer be able to
deny coverage or charge higher premiums for people with health
Combined, those measures should make it easier for women to get
access to health insurance if they don't get coverage through their
own employers, Lavelle says.
Take action if your marriage hits the rocks
Don't wait until the divorce is final to think about health
insurance. Start exploring options as soon as you can, says Colleen
Callahan, president of CCIS, an independent insurance agency in
Pleasant Hill, Calif.
"There's often a lot of confusion about what's available," she
says. So give yourself plenty of time to research your options.
Another reason not to wait: The projected costs for coverage and
out-of-pocket medical expenses should be considered during the
divorce settlement negotiations, says Lili Vasileff, president of
Divorce & Money Matters LLC in Greenwich, Conn., and president
of the International Association of Divorce Financial Planners.
Add up your potential costs including the health insurance
premium and out-of-pocket costs such as copayments for doctor
visits, deductibles and co-insurance, to include in your
post-divorce budget, Vasileff says. If affording a health plan is
impossible, estimate how much medical care will cost without
You may need to consult a health insurance agent, financial
planner or employee benefits consultant to get good numbers.
Divorce attorneys sometimes take a broad-brush stroke when it comes
to health insurance and other financial details during the
negotiations, Vasileff says. "Generally the nuances don't come to
the table. All those little pieces don't get examined carefully
Here are health insurance options to consider.
Your own employer's health plan
Ask to enroll in coverage at work if your employer offers it.
Federal law says you can enroll outside the annual open enrollment
period if you've lost access to health insurance coverage
elsewhere. Looking for work? If you're fortunate to find a job that
offers health benefits, find out how long you'll have to wait to
enroll. Then plan how to fill the insurance gap during the waiting
period, typically 30 to 60 days for new employees.
The federal Consolidated Omnibus Budget Reconciliation Act lets
you continue coverage through your ex-spouse's employer-sponsored
health plan for up to 36 months after divorce, if the employer has
at least 20 workers. (Many states have similar laws that apply to
employers with fewer than 20 workers.) You have to pay the full
premium, plus up to a 2 percent administrative fee. You have 60
days after you lose coverage to decide whether to elect COBRA.
Know your COBRA rights
Prepare for sticker shock. Without the employer chipping in, the
premiums can be pricey. Contact your spouse's employee benefits
department to find out how much you would pay for COBRA, and review
the plan to learn about out-of-pocket costs, such as deductibles
Individual health insurance plan
If you're young and fairly healthy, you might find more
affordable coverage than COBRA by purchasing an individual health
plan. Plus, under the Affordable Care Act, starting in 2014 health
insurers will not be allowed to deny coverage or charge higher
premiums for people with health conditions. Until then, insurers
consider your health history when you apply for individual
Don't count yourself out if you have a condition, Callahan says.
"There is a continuum between yes and no."
Even if you have a medical condition, you might be able to buy
coverage at a higher-than-standard rate, which is better than no
coverage at all.
Find a patient, independent insurance agent who's willing to
walk you through the options, Callahan says. The
National Association of Health Underwriters
provides an online tool
to find agents.
Compare the costs and benefits of available plans, and don't
forget to check whether your doctor and hospital are in the
provider network. Here's how to buy the worst health insurance plan
ever: 7 scenarios to avoid.
Can't afford coverage? Check whether you qualify for Medicaid,
the federal and state health insurance program for low-income
people. The Foundation for Health Coverage Education provides
information about other programs in your state.
If you're uninsured and don't have access to employer-sponsored
coverage or COBRA, then you might qualify for the Pre-existing
Condition Insurance Plan, a federal program created under the
Affordable Care Act. To qualify, you must have been uninsured for
at least six months and have a health condition that makes it
difficult to qualify for a private individual health plan. You foot
the bill for the premium.
Are you turning 65? Then you're eligible for Medicare. Go to
Medicare.gov to learn about your options.
Your own business
Consider getting coverage through your own business if you're
self-employed. Even tiny employers can qualify as "groups" for the
purpose of buying health insurance. In California it takes just two
people to be a group, Callahan says.