Health Insurance After a Spouse Dies

When does your current coverage end?

Call your spouse's benefits office and ask for the last day of coverage for you and each child on the plan. The answer depends on the plan's rules. Don't assume coverage ends on the day your spouse died, or that it lasts through the end of the month.

Ask them to confirm the date in writing and send you the options for keeping the plan. You'll need the monthly cost and the deadlines for signing up and paying. Keep that notice. It will help you compare other insurance and prove when your old coverage ended.

Can you join the plan at your own job?

If you turned down insurance at work because you had coverage through your spouse, contact your own benefits office now. Losing your spouse's coverage may let you and your children join your employer's plan. You must otherwise be eligible for it.

Ask for special enrollment, which means permission to sign up outside the usual enrollment period. Request it within 30 days after your old coverage ends. If you qualify and apply on time, coverage must begin by the first day of the month after the plan receives your request. Get the exact start date, especially if your old plan ends in the middle of a month.

Keeping your spouse's plan through COBRA

COBRA is a federal law that lets eligible family members keep an employer's health plan for a limited time. After an employee dies, a spouse or dependent child who was covered the day before the death may qualify for up to 36 months. Each eligible person can choose separately.

Keeping the plan can mean less disruption to ongoing care, but the price can be a surprise. You may have to pay the share your spouse's employer used to pay, as well as your own share and an administrative fee. Ask for the full monthly amount, called the premium.

You must have at least 60 days to choose COBRA, counted from whichever comes later: the date coverage ends or the date the plan provides your enrollment notice. After you choose it, you have at least 45 days to make the first payment. That payment may need to cover earlier months too. Check the amount and due date before signing up.

Federal COBRA generally applies when an employer has at least 20 employees. Federal employee plans and some church plans have different rules. In Texas, some plans also offer coverage extensions under state law, including when federal COBRA isn't available. Texas rules don't cover self-funded plans, where the employer pays the claims. Ask the benefits office which rules apply to your plan.

Buying a plan through the Marketplace

The health insurance Marketplace is where you can compare and buy individual or family plans. HealthCare.gov can direct you to the Marketplace for your state. You can look at these plans before deciding whether to take COBRA.

For a qualifying loss of coverage, HealthCare.gov allows enrollment during the 60 days before or after your insurance ends. Save proof of the loss and check when the new plan would begin. Waiting for a COBRA notice doesn't extend this deadline.

The application also checks whether you qualify for help paying for a Marketplace plan, Medicaid, or the Children's Health Insurance Program, known as CHIP. Medicaid and CHIP provide free or low-cost coverage to eligible people. They accept enrollment year-round.

Be careful about choosing COBRA with the idea of switching later. Once your original enrollment window closes, voluntarily dropping COBRA doesn't, by itself, let you enroll in a Marketplace plan. You would need annual Open Enrollment or another qualifying reason, such as COBRA running out.

If you're eligible for Medicare

If you put off Medicare Part B because you had insurance through your spouse's current job, check your enrollment deadline before choosing COBRA. Part B helps cover doctor visits and other medical services.

COBRA doesn't extend the time you have to enroll in Part B. Waiting until COBRA ends can leave you with a gap in coverage or a late-enrollment penalty. A counselor through your State Health Insurance Assistance Program can help you work out the dates at no charge.

Before you choose a plan

A lower monthly bill doesn't always mean lower costs overall. Check whether each plan covers your doctors and prescriptions. Compare what you'd pay for appointments and medicine, too.

Ask about the deductible, the amount you pay for certain covered care before the plan begins sharing those costs. If you've already paid toward a deductible this year, find out whether switching plans would mean starting again.

Finally, confirm the day the new coverage starts and what you must pay to activate it. Save the enrollment confirmation and payment receipt for everyone who signs up. If there's a gap between the old plan and the new one, ask the benefits office how you can cover those days before making your choice.