Medicare and Divorce

By Stephanie Dube Dwilson

Health insurance coverage based on your spouse can sometimes last far beyond the length of the marriage itself. If you're divorced and approaching the age where you qualify for government-sponsored Medicare, your former marriage may help you obtain coverage.

Medicare

Medicare is a health insurance plan offered by the federal government for people who are age 65 and older, or for some younger people who have certain illnesses. Medicare Part A, hospital coverage, is free. Part B, medical insurance, is available for an extra monthly premium based on your income. Part C, the advantage plan, is for people who want even more options. These can include a preferred provider organization plan with more doctors in network or a fee-for-service plan. Medicare also has a prescription drug plan for a small additional cost.

Qualifications After Divorce

Typically, a person qualifies for Medicare at the age of 65 if he worked about the equivalent of 10 years and also qualifies for Social Security. If you didn't work enough to qualify and are divorced, you may still qualify based on your ex-spouse's work record. If your ex-spouse qualifies for Medicare, you're 65 or older and were married for at least 10 years, you can get coverage through your former spouse. If you've remarried since your divorce, however, you no longer qualify for Medicare based on your ex-spouse.

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Cost-Based Divorces

Medicare's coverage options for divorced spouses may indirectly encourage some spouses to break up. Medicare Plan A only covers the most basic services. It doesn't cover long-term rehabilitation, assisted living, at-home nursing or clinical trials. Medigap policies, which help fill in the gap that Medicare doesn't cover, often charge premiums based on a person's income. It's not unheard of for spouses to choose to divorce so that the sick spouse can have an income of zero and qualify for cheaper Medigap premiums, even if he's qualifying based on his divorced spouse's work history.

Divorce's Impact on Income

If you're receiving any type of Medicare besides the free Plan A version, you are likely being charged premiums based on your income. The basis may be calculated according to your income from two years prior. If you've divorced and your income decreased as a result, you may qualify for a lower premium. To get the government to look at evidence besides your last two years of income, you can request a new decision based on a life-changing event and provide proof of your life-changing event to qualify.

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Divorce Laws on Court-Ordered Health Insurance

References

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Georgia Health Insurance Laws Concerning Divorce

Many spouses have health insurance coverage through their spouse’s group plan, but that eligibility changes when they divorce. If one spouse is receiving health insurance benefits through the other spouse’s plan, the receiving spouse must elect coverage under COBRA if she wants to remain on that plan once the divorce is finalized.

Can a Divorced Spouse Collect on Disability Benefits or Social Security Income?

Social Security generally pays out three types of benefits: retirement, disability and Supplemental Security Income, or SSI. To receive the first two, an individual must have paid into the system. SSI is administered by the Social Security Administration but is not paid from payroll taxes, therefore, you do not have to have paid into the system to qualify. Your ex-spouse may be eligible to receive certain of these benefits based on your work record.

New York State Health Insurance Rules When Getting a Divorce

New York does not require health insurers to provide health insurance for divorced spouses, so one spouse may lose health insurance when she divorces if she was covered by her husband’s plan. New York law even requires divorcing spouses to acknowledge they are aware they will no longer be allowed to receive health care coverage under a former spouse’s insurance plan once the divorce is final.

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