If you have lost your spouse and were on their health insurance policy, you might be wondering what will happen to your health insurance now that they are gone. The death of a policyholder is considered a Qualifying Life Event and allows you, the surviving spouse, and any dependents, to apply for a new health insurance plan.
Our independent insurance agents at McKnight & McKnight Insurance Solutions are here to help you navigate health insurance after the death of a loved one. Here is what you should know.
How the Death of a Spouse Triggers a Qualifying Life Event
Qualifying Life Events (QLEs) trigger a Special Enrollment Period (SEP), which allows you to apply for health insurance outside of Open Enrollment. The death of a spouse who is the policyholder in your household is considered a QLE.
Typically, a QLE will trigger a 60-day Special Enrollment Period
in which you can apply for a new healthcare plan.
What Options Do I Have for Health Insurance?
Now, let’s discuss some of your options for health insurance.
Spouses, partners, and children are often covered on a health care plan that is sponsored by an employer. When the employee passes away, dependent coverage ends, usually after some kind of grace period. It is important to contact the human resources department of your spouse’s employer to determine how long your plan will continue and what options, like COBRA, you might have.
COBRA, or The Consolidated Omnibus Budget Reconciliation Act, allows dependents covered under an employer-sponsored health plan to extend their coverage up to 36 months. In this case, you typically will have 60 days from the day your loved one passed away to sign up.
Keep in mind, COBRA is expensive. You will be responsible to pay the full premium cost, including the portion of the premium that your spouse’s employer was paying. You may also be responsible for an additional 2% of the total insurance premium, which pays for the administrative costs that the employer previously paid.
Though it is expensive, if you are in the middle of an expensive course of medical treatment, have already satisfied your deductible, or need to keep your existing providers, you may find that COBRA is the best short-term choice.
More About COBRA> How to Find Health Insurance After COBRA Ends
Affordable Care Act Plans
Typically, you can only enroll in health insurance once a year during the annual Open Enrollment Period. But as stated above, if you have a QLE, like the death of a policyholder, you may be able to enroll during a Special Enrollment Period.
To verify your eligibility, you may need to submit certain documents that confirm your QLE. In the case of the death of a spouse, you will need a letter from your health insurance company showing either the termination of, or the upcoming termination of your coverage.
After your QLE is verified, you will be able to shop for a new health care plan.
If a reduction in family income occurs due to your loss,
you may qualify for government-sponsored premiums
subsidies or cost-sharing programs.
Remember, you have 60 days during your Special Enrollment Period to enroll in a new plan. Don’t miss the deadline! After your SEP closes, you will have to wait for Open Enrollment to apply for health insurance.
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What Happens If Your Loved One Was on Your Health Insurance?
If your loved one was covered under your employer-sponsored insurance or a private insurance plan, you will need to notify your employer’s human resources department or your health insurance provider as soon as possible. Your premium and other associated costs may change as a result of losing a dependent on your plan.
If your loved one was a dependent on your Affordable Care Act plan, you are eligible for a Special Enrollment Period to change plans if necessary.
Since Medicare coverage is based on the individual and does not include dependent coverage, you will need to inform Medicare or your loved one’s Medigap insurer of your loss, so premium and other billing stops.
Your coverage may be affected if you receive health care benefits as part of your spouse’s retirement package from a former employer. It is up to the plan to set guidelines for surviving spouses, so make sure to check with the insurer for details.
Apply for a New Health Insurance Plan
The death of a spouse or family member can have a substantial impact on the future of your health insurance coverage. If you need help navigating health insurance following the death of a loved one, our compassionate independent insurance agents at McKnight & McKnight Insurance Solutions can help!
Call McKnight & McKnight to get started with a complimentary quote today. We look forward to helping you find a new health insurance policy.