lucky to have a full-time job that
offers health insurance, but she’s
uncertain whether she can get
affordable full coverage for her
pre-existing condition.
Exploring COBRA
In all states, an ex-spouse is
eligible for coverage under
COBRA (the Consolidated
Omnibus Budget Reconciliation
Act) for 36 months as long as the
employer that provided the benefits has 20 or more employees,
the ex-spouse was enrolled in the
employer’s group plan at the time
of divorce and the ex-spouse can
afford the full cost of the premium. People with pre-existing
conditions cannot be excluded
from COBRA, though this can
be cold comfort. Many, like
Clevenger, can not afford new
expenses post-divorce.
COBRA payments are an
“enormous sticker shock for most
people,” said Kimberly Calder,
MPS, director of Federal Health
Affairs and Insurance Policy
at the National MS Society.
“COBRA simply says you have
a legal right to stay on your old
group plan for a period of time
after a life change, but you have
to pay 100% of the premium
plus a 2% administration fee.”
The rules for smaller employ-
ers (less than 20 employees) vary.
Contact your state department of
insurance to find out about your
state’s health coverage continu-
ation laws. Medicare Access for
Patients Rx offers a listing of
resources, including state-specific
information at maprx.info/
states.php.
A possible legal out for
divorcing couples
Mandel also advises people to
think of insurance as a shared
asset to be divided by the divorce.
“Divorcing parties can protect
themselves by seeking to legally
compel their spouse to obtain an
independent medical insurance
policy as part of the settlement,”
he said. “Health insurance may
be negotiated in the same way as
alimony or child support.”
Domestic partnerships
COBRA does not recognize
domestic partners as “qualified
beneficiaries,” so it is not an
option for unmarried couples,
including most same-sex couples.
But states that recognize gay
marriage can require insurance
companies to extend marital and
divorce benefits to married gay
couples. Places that only recognize civil unions or partnerships,
or do not formally recognize gay
couples at all, may allow coverage
to be granted at the discretion
of the insurance company. The
National Conference of State
Legislatures offers a comprehensive list of states that recognize
civil unions and domestic partnerships, and the rights available
in each state: ncsl.org/default
.aspx?tabid=4244.
The Affordable Care Act
(Health Care Reform)
Most changes in the 2010 Patient
Protection and Affordable Care
Act won’t take effect until 2014,
but there are now Pre-Existing
Condition Insurance Plans
(PCIPs) that guarantee coverage
for people who:
Make a call
“Don’t feel doomed to go
without coverage. Call an MS
Navigator at 1-800-344-4867 for
more help. Also ask about any
insurance assistance programs in
your state for people with limited
incomes.” And visit our online
resources at nationalMSsociety
.org/healthinsurance.
In 2014, the Affordable
Care Act will establish health
insurance exchanges and other
cost-saving systems to ease this
difficult situation. n
Emily Wojcik is a freelance writer in
Northampton, Mass.
