How Health Insurance Works When Parents Are Divorced

Who pays for your child's health insurance after divorce

After a divorce, one parent usually keeps the child on their employer health plan, or one parent buys a plan through the marketplace. The divorce decree or custody agreement often specifies which parent is responsible for providing coverage and which parent pays for it — these are two separate decisions. A parent might provide the insurance but the other parent might be ordered to reimburse them for the premiums.

If neither parent has employer coverage, you can buy a plan through your state's health insurance marketplace during open enrollment (usually November through January), or you may may have access to for Medicaid or CHIP (Children's Health Insurance Program) based on household income. The income limit depends on which parent's household the child lives in, and that matters — it's not combined household income.

The key thing to know: the divorce paperwork should say who provides insurance and who pays. If it doesn't, or if circumstances have changed since the divorce, you'll need to sort this out with the other parent or ask the court to clarify the order.

Key Takeaways

• The divorce decree should specify which parent provides health insurance and which parent pays for premiums, but these can be assigned to different parents.
• If a parent loses employer coverage through job loss or a job change, they must tell the other parent and work out a new plan within 30 days to avoid a gap in coverage.
• Income limits for Medicaid and CHIP are based on the household where the child lives, not both parents' combined income.
• If the parent responsible for insurance isn't providing it, you can file a motion with the court to enforce the order or modify it.

When a parent's job changes or they lose coverage

If the parent providing insurance loses their job or changes jobs, they usually have 30 days to notify the other parent and arrange new coverage. This is called a may have access to life event, which means you can buy a marketplace plan outside the normal open enrollment window — you don't have to wait until November.

The parent who lost coverage should contact their state's health insurance marketplace right away and explain the job loss. You'll need to provide the date coverage ended. If the child qualifies for Medicaid or CHIP based on the household income, that's often faster than buying a marketplace plan and costs less or nothing.

If the parent responsible for insurance doesn't arrange new coverage within 30 days, the other parent can buy a plan and then file a motion asking the court to order the first parent to reimburse them. Keep documentation of when you learned about the coverage lapse and when you bought the replacement plan.

Medicaid and CHIP for children of divorced parents

Both Medicaid and CHIP look at the income of the household where the child lives. If your child lives with you most of the time, only your income counts — not the other parent's income, even if they're required to pay child support. This means a child might may have access to for Medicaid or CHIP through one parent's household even if the other parent has a higher income.

You can apply for Medicaid or CHIP through your state's health department or social services office, or through your state's health insurance marketplace. The application asks which parent the child lives with and how many people are in that household. Income limits vary by state and change each year, but generally a child qualifies if the household income is below 200% to 400% of the federal poverty level, depending on the state and the program.

If your child is already on Medicaid or CHIP and you move to a different state after a divorce, you'll need to apply in the new state. Coverage doesn't transfer between states, though some states have processes to help with the transition.

What to do if the other parent isn't providing insurance

If the divorce order says the other parent must provide insurance and they haven't, your first step is to ask them directly — in writing, by email or text — to provide proof of coverage or to tell you what plan the child is on. Keep this communication. If they don't respond or refuse, you have two options: buy coverage yourself, or file a motion with the court.

If you buy coverage yourself, keep all receipts and documentation. You can then file a motion asking the court to order the other parent to reimburse you for the premiums. The court can also modify the original order if circumstances have changed — for example, if the parent who was supposed to provide coverage no longer has access to an employer plan.

Some states have child support enforcement offices that can help enforce health insurance orders as part of the overall child support case. Contact your state's child support enforcement agency (usually part of the Department of Human Services or similar) to ask whether they can intervene.

Marketplace plans and tax credits for divorced parents

If you're buying a plan through the health insurance marketplace for your child, you may be able to claim a tax credit that lowers your monthly premium. The credit is based on your household income and the number of people in your household. For divorced parents, "your household" means you and the children who live with you — not the other parent.

When you apply for a marketplace plan, you'll report your income and household size. If your income is between 100% and 400% of the federal poverty level, you'll likely may have access to for a tax credit. The marketplace will estimate your credit and apply it to your monthly bill. At tax time the following year, you reconcile what you received against what you were actually owed based on your final income.

If the other parent is also buying a plan for the child (which shouldn't happen, but sometimes does), only one of you can claim the child as a dependent for the tax credit. This is another reason to make sure the divorce order clearly assigns insurance responsibility to one parent.

Keeping coverage continuous when custody changes

If custody changes after the divorce — for example, the child moves to live with the other parent — the insurance situation needs to change too. The parent who now has primary custody should be added to or become the main contact on the insurance plan, and the premium responsibility should shift if the order requires it.

A change in custody is a may have access to life event that lets you change plans or add a dependent outside the normal enrollment window. Contact the insurance company or the marketplace to report the change. If the child was on Medicaid or CHIP through one parent's household and now lives with the other parent, you'll need to reapply in the new household.

If the custody change is temporary — for example, the child spends the summer with the other parent — the insurance doesn't need to change. But if it's permanent or long-term, update the insurance records so the parent with custody can make medical decisions and receive bills and notices.

What happens if your child ages out of coverage

Most health plans cover children until age 26, but some employer plans end coverage at age 19 or 21 if the child is not in school. Check your specific plan's rules. If your child will age out soon, start looking at marketplace plans or Medicaid for young adults in your state.

Some states extend Medicaid coverage to young adults up to age 26, while others end it at 18 or 19. Your state's Medicaid office can tell you the age limit. If your child will lose coverage, you can buy a marketplace plan during open enrollment or if a may have access to life event occurs (like aging out of a parent's plan, which counts as a life event).

If your child is in college, they may be able to stay on a parent's plan even after the normal age limit, depending on the plan. Some colleges also offer student health plans. Ask your child's school what options are available.

Frequently Asked Questions

Can I put my child on my health plan if the other parent is supposed to provide insurance?

Yes. If the other parent isn't providing coverage or you need to add your child to your plan for any reason, you can do so. You can then ask the court to order the other parent to reimburse you for the premiums, or to modify the original order. Keep documentation of when you added your child and what you paid.

Does the other parent's income affect whether my child qualifies for Medicaid or CHIP?

No. Medicaid and CHIP only look at the income of the household where the child lives. If your child lives with you, only your income counts, even if the other parent earns more or is supposed to pay child support.

What if both parents have employer health plans and want to cover the child?

The child can only be on one primary plan. The other plan becomes secondary and covers costs the primary plan doesn't. The divorce order should say which plan is primary. If it doesn't, the plan of the parent with custody is usually primary, but check your specific plans' rules.

Can I change my child's insurance without the other parent's permission?

If you have primary custody and the order assigns insurance responsibility to you, yes. If the order assigns it to the other parent, you should try to agree on any changes. If you can't agree and the current plan isn't working, you can file a motion to modify the order.

What if I'm behind on child support — does that affect my child's health insurance?

Child support and health insurance are separate obligations. Being behind on child support doesn't automatically end health insurance, but the other parent can file a motion asking the court to enforce both orders. If you're having trouble paying either, contact your state's child support enforcement office to discuss your options.