One of the most important considerations during a divorce is how your child’s medical insurance and expenses will be paid following the dissolution of your marriage. Most insurance companies prohibit policyholders from keeping ex-spouses on their plans. However, North Carolina law requires divorcing parents to provide health and dental insurance coverage for their children if the costs are reasonable.
If one parent’s employer or the other’s provides a group health insurance plan, that plan will likely be at a reasonable cost. The separation agreement needs to specify which parent will pay for the children’s health insurance after a divorce to avoid litigating the issue in court.
As you contemplate a separation agreement and health insurance options for your child and your own health insurance, an experienced divorce lawyer at Charles R. Ullman & Associates can advise you about health insurance costs and negotiate a separation agreement that protects your financial interests.
Contact us today to discuss how to be sure that your child has health insurance and dental and vision coverage after going through the divorce process. Our family law firm represents clients throughout Raleigh and Wake County.
Legal Framework: Rights, Obligations, and Court Orders
As a parent, you want your child to have uninterrupted health insurance coverage despite your divorce. Under the law in North Carolina, the parties to a divorce may enter into a written agreement as to how their child’s medical care will be paid for, or the court may order a parent or other responsible party to provide medical support for the child. This includes maintaining health insurance if it is available at a reasonable cost.
In many marriages, one spouse and the children receive medical care through the other spouse’s employer-sponsored health insurance program. In a divorce, a spouse who seeks child custody but does not have health care coverage available through their employer or other means can ask to have health insurance provided for the children as part of the divorce settlement.
The uninsured spouse may seek help with health insurance costs as part of the divorce settlement, too, but there is no legal requirement in North Carolina for anyone to provide health care insurance to a former spouse.
When a court considers whether to accept a separation agreement and adopt its provisions as a divorce settlement, it will base its decisions on what is in the child’s best interest. It will almost certainly order a spouse with access to employer-sponsored health insurance to insure their children, regardless of which parent has primary custody of them.
A family law court is concerned with what is fair and equitable within each party’s circumstances in a divorce. Therefore, the court may determine that the parent who cannot provide insurance should contribute to the other’s insurance costs. Under the law, health insurance for a child is available at a reasonable cost if its price does not exceed 5% of the parent’s gross income. For measure, 5% of $50,000 is $2,500.
In short, in addition to the law, North Carolina Child Support Guidelines direct the court to order one parent or the other to maintain health insurance coverage for a child if it is available at a reasonable cost. The other parent may be required to help pay its cost if they are capable.
The cost of children’s health care coverage may be balanced by adding to or deducting from child support payments or adjusting alimony payments accordingly. If both parents can enroll their child in group insurance plans, then one plan can be designated primary coverage for the child, and the other can be secondary coverage.
Navigating Current and Future Insurance Availability
It is unlikely that a group health plan will provide health insurance coverage to employees’ former spouses. If it does, it will be more expensive than coverage for immediate family members.
A divorced spouse who was on their ex’s health insurance plan may have a right to COBRA coverage extension, a federal program that provides up to three years of health insurance availability at full costs, plus a 2% administrative fee. The program applies to companies with 20 or more workers. As of 2024, the average COBRA monthly insurance premium ranges from $400 to $700 per individual, depending on the cost of the original insurance coverage.
When employer-sponsored insurance or COBRA coverage is unavailable, an ex-spouse may obtain coverage through the health insurance marketplace public exchanges established by the Affordable Care Act (Obama Care). Divorce is one of the qualifying life events that allows access to health insurance outside of the annual Open Enrolment period.
At age 65 or upon contracting a qualifying disability, an individual becomes eligible for Medicare, the federal government insurance program for the elderly and disabled. Once an individual begins to receive Social Security retirement or disability benefits, federal law requires enrollment in Medicare Part A (hospitalization) and Part B (medical). Part C (Medicare Advantage Plans) and Part D (drug coverage) are optional.
Let Our Raleigh Divorce Lawyers Help
The divorce attorneys at Charles R. Ullman & Associates offer a thorough review of your and your spouse’s financial standing as part of the legal services we provide clients. Our goal is to help clients make forward-looking decisions when developing a separation agreement. We want to protect your financial interests and make sure that you and your children have uninterrupted health insurance coverage as your divorce is finalized. That includes making sure that your health coverage needs and your child’s healthcare insurance needs are covered, either by an existing insurance plan or new insurance coverage.
Our first aim is to negotiate an equitable separation agreement that a family law judge can approve. In case it becomes necessary, we will be prepared to defend our proposals and raise valid challenges to the other spouse’s plan on our client’s behalf.
Contact us today to speak to an experienced North Carolina divorce attorney from our firm. We have helped numerous Wake County residents, including clients from Raleigh and Cary, who were in situations like yours.
