Health Insurance After Divorce in North Carolina

Health Insurance For Former Spouses: What You Need to Know

Divorce changes many aspects of life, including health insurance. Many people don’t realize that losing coverage can be one of the most significant financial and medical consequences of ending a marriage. For spouses with chronic health conditions, the loss of coverage can be especially concerning.

Failure to provide notification of a divorce or separation may be considered insurance fraud. In the event of a divorce, women have a higher chance of losing health insurance coverage and then remaining uninsured for years after the divorce.

In North Carolina, health insurance after divorce is governed by state law, federal regulations, and the terms of a couple’s settlement agreement. Below, we break down what you need to know to protect your health and your children’s coverage.

Coverage for Former Spouses

Once a divorce is finalized, most employer-sponsored health insurance plans will no longer cover an ex-spouse. In some cases, settlement agreements may require one spouse to help pay for the other’s health insurance for a set period of time. The agreement might cover:

• Premiums for private insurance or COBRA continuation coverage

• A specific time limit (such as one or two years)

• Long-term or lifetime coverage in rare situations

Because women statistically face a higher chance of losing health insurance after divorce, it’s crucial to plan ahead and review your options before separation.

Health Insurance for Children After Divorce in North Carolina

Children are often the focus of medical coverage discussions during divorce. Parents may agree – or the court may order – how insurance responsibilities are divided. Options include:

• Coverage under a parent’s employer group plan

• Private health insurance purchased individually

• Cost-sharing between parents, either equally or in proportion to their incomes

When both parents have group health plans, one plan may be considered “primary” and the other “secondary.” The secondary plan covers expenses not paid by the primary plan. Parents should consider not just premiums, but also co-pays, deductibles, and out-of-pocket medical costs.

If a child has a pre-existing medical condition, it may be especially important to avoid switching plans unnecessarily.

Unfortunately, former spouses do not always honor the agreements made on insurance and other issues. Parents can create a contract with the children’s doctor, specifying which parent is responsible for what costs. For example, the parents may agree to divide bills 75/25. The parents would then each be billed separately.

North Carolina Court Requirements for Child Health Insurance

North Carolina law requires parents to provide health and dental insurance for children when it’s available at a reasonable cost. Employment-based and other group health insurance policies are deemed “reasonable.” North Carolina courts can order parents to pay a child’s medical expenses as a type of child support.

Courts can order one or both parents to:

• Provide medical, dental, or hospital coverage

• Pay out-of-pocket medical expenses

• Share costs proportionally to income

If the parent responsible for coverage changes jobs, the new employer must enroll the child in the employer’s plan

The court can order a parent to provide medical support for the child, or the parties may enter into a written agreement. An order or agreement for medical support may compel one or both parents to pay medical, hospital, dental, or other health-care-related expenses.

Communication and Enforcement

The parent ordered or under agreement to provide health insurance must provide written notice of changes in the applicable insurance coverage to the other parent. The employer or insurer of the party required to provide health, hospital, and dental insurance must release upon request to the other party any information on a child’s insurance coverage that the employer or insurer may release to the party required to provide insurance.

Under a court order or agreement for health insurance, the signature of either parent is valid authorization to the insurer to process an insurance claim on behalf of the minor child. If the parent who is required to provide health insurance fails to maintain coverage for the minor child, the parent will be liable for any health, hospital, or dental expenses incurred from the date of the court order or agreement that would have been covered by insurance.

Planning Ahead for Health Insurance After Divorce

Losing coverage after a divorce can be stressful, but planning ahead helps avoid gaps. Options may include:

• COBRA coverage (temporary continuation of employer-sponsored insurance)

• Marketplace health plans under the Affordable Care Act

• Coverage through a new employer

• Coverage options for children if private insurance isn’t available or affotdable

Whether you’re the spouse at risk of losing coverage or the parent responsible for a child’s insurance, it’s important to review your options early in the divorce process. Consulting both your attorney and your insurance provider can help protect your health and finances.

Overall, it’s important for couples to understand the health insurance rights and options for themselves and their children when getting a divorce. Spouses should research the best way to obtain insurance. If a spouse fails to consider his or her options prior to separation, they could be stuck paying a higher cost or even risk losing insurance coverage.

The Law Office of Dustin McCrary – Protecting Your Health and Your Future

Divorce can bring many uncertainties, and questions about health insurance are often some of the most stressful. Whether you’re concerned about losing your own coverage or making sure your children remain protected, these decisions can feel overwhelming during an already difficult time.

At the Law Office of Dustin McCrary, we help families in North Carolina navigate the legal and financial challenges that come with divorce, including issues of health insurance and medical support. You don’t have to figure it out alone. We’re here to guide you with compassion and clarity. Contact us today to discuss your situation and take the next step toward protecting your family’s future.