Health Insurance After the Death of a Spouse, or any other Policy Holder

Health Insurance After the Death of a Spouse, or any other Policy Holder
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The death of a spouse or a family member who was your policyholder can really affect your health insurance coverage plan. Suppose your health insurance is covered by your family member who just passed away. In that case, you need to take the necessary steps to ensure continued coverage. In case you are covering the health insurance of your spouse or other family members, you may still need to take some steps.

But before that, you must know about the type of insurance you have. To elaborate more properly, we have discussed some of the scenarios that other people or you might face in these situations.

Your Deceased Family Member’s Insurance was Covering You

Employer-Sponsored Insurance

Their employers cover most of the time, spouses, children, or partners up to age 26. If the employee dies, after some grace period, the dependant health insurance coverage will end. So to avoid this, you need to contact the HR department of your loved one’s employer and confirm:

  • How long the coverage will continue for you?
  • And what are the other options you may have?

Employers with 20 or more than 20 employees usually offer a COBRA Plan for children depending on the employer’s coverage and the spouse.

It is also known as Consolidated Omnibus Budget Reconciliation Act. This program allows the dependant covered under the employer-sponsored plan to extend the coverage period up to 36 months. To sign up for the COBRA Plan after the death of your spouse or family member, you have a time of 60 days.

Because the COBRA Plan is expensive, you may still be paying the full premium cost, including the 80% covered by the employer before. Furthermore, you will also be covering the administrative costs of 2% that the employer covered before the death of your loved one. So all and all, you will see a significant increase in the premium costs.

That said, some family members might not be able to afford the hefty cost of the COBRA Plan. The reason is that the cost of the COBRA plan will stay the same as before the employee’s death. 

People falling in the following two categories will find COBRA the best choice for them after the death of a loved one:

  • Already in the middle of their course of treatment and have already satisfied their allowances 
  • Or the ones wanting to keep their existing network of providers 

Health Insurance After the Death of a Family Member

Affordable Care Act (ACA) Exchange-Based Plans

Lose of a family member or a spouse qualifies you for the special enrollment period. You can easily enroll for the exchange-based plan under the Affordable Care Act. More so, if you lost employer-sponsored insurance after the death of your spouse or another family member, you can apply for the exchange-based plan in a time of 60 days. This way, you won’t have to wait for the annual open enrollment period.

If you still have an exchange-based plan, the special enrollment period will still be available for you. Because after losing your spouse or a family member, you may want to have different coverage with an alternate ACA Plan. If losing a family member results in loss of family income, you may:

  • Qualify for government-sponsored premium assistance 
  • Or programs for exchange members that will allow them to share costs

To know if you qualify for government assistance, you can find it on Healthcare.gov according to your state.

Related Articles:

When Your Plan Covers a Deceased Family Member

If your deceased spouse or a family member was being covered by your employer-sponsored plan insurance or any other insurer, then you would need to inform your employer’s human resources department or your insurer as soon as possible. Because having one less dependant may reduce your overall premium cost.

Suppose you included your family member on the exchange-based plan. In that case, you will be eligible for the special enrollment period to change the plan if you are required to. As mentioned above, if losing a family member causes a downfall in your income, you may qualify for government-sponsored cost assistance.

Consideration For Retirees

If Medicare was covering the family member you lost, they won’t cover you anymore. Because you should know, that Medicare recipient has separate coverage, and the same could be said about the Medigap recipients. So make sure to inform both of them about your loss. Because this way, you will not receive any more premiums and other billings when the coverage is stopped.

Suppose your health benefits were part of your spouse’s retirement package from their former employer. In that case, after their death, your coverage plan may be affected. To know more details, you need to contact the plan administrator.


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