Should I get a divorce to protect my husband and child?

October 8, 2011 1:21 PM

If I test positive for cancer, should I divorce my husband so I won't max out his insurance?

My husband and I have a child and in the event that the tumor I have is cancerous, should I divorce him so that his health insurance doesn't dump them? I am afraid cancer treatment will max out the annual spending and then he and my daughter will not be able to get coverage for anything they need.

Would I be better off to get a divorce and purchase state insurance for myself or should I just pay out of pocket?

We live in the US and our health insurance is Blue Cross Blue Shield provided by his company. He works as a full-time staff salaried employee and I am a freelance employee.

posted by anonymous to Health & Fitness (13 answers total)

Before you do anything so drastic, please review your actual conditions of coverage. Two of the benefits of the Affordable Care Act (aka health care reform) are:

-- no one can be dumped from their insurance for health conditions
-- no lifetime dollar limit on coverage, and restricted annual limits.

Fact sheet
Timeline for implementation of changes. (That site has a wealth of accurate, helpful information)
posted by gingerbeer at 1:30 PM on October 8, 2011 [10 favorites]

In some states, you can have separate insurance without a divorce. In our case, husband has the costly health issues and insurance through work; I bought self-pay insurance for myself and our child.
posted by xo at 1:40 PM on October 8, 2011

I can't tell if this is hypothetical or if you have an actual tumor that you are in the process of having biopsied (it might help if you follow up with one of the moderators here to clarify).

In any case, though, gingerbeer is correct: do not assume that you will max out his insurance. Even before the health care reform bill passed, not all insurance policies had low limits anyway that would be maxed out by cancer treatment. Also, not all cancer treatment is astronomically high -- many cancers can be treated with surgery alone, or with surgery and a short course of radiation (which can be pricey but, depending on the kind and duration, not necessarily bank-breaking pricey), or with chemo that's available as a pill (again, not super-cheap, but by no means so expensive as to max out your lifetime limits).

Also, if there is any thought that a tumor you presently have might be cancerous, that may make it trickier (and almost certainly very expensive) to get insurance on your own right now because it's a pre-existing condition. Again, due to health care reform, I don't think you'd be totally excluded from getting individual coverage, but it doesn't mean it would be affordable.

In short, do NOT do anything rash until you have investigated the full terms of his policy, and until you know more about the medical situation you are facing.
posted by scody at 1:44 PM on October 8, 2011 [2 favorites]

IANAL nor a health benefits professional, but in my personal experience both Blue Cross Traditional and Blue Cross PPO will not cut a person from their enrollment if they rack up a ton of medical expenses. The employee's particular plan might have a "cap" as to how much Blue Cross will pay and how much of the remainder the insured person will be responsible for. And in my experience (I used to handle the Blue Cross accounts/issues/enrollment at two different jobs) one employee in a company undergoing extensive chemotherapy or a heart transplant did not automatically increase the employer's premium. Blue Cross Traditional and PPO had certain set rates that applied to all of their clients. (Blue Cross' HMO might be different.) During the time I handled employee health coverage, we had folks (or their spouses/family members) who'd undergone hip replacements, breast cancer surgery and chemo follow-up, prostate cancer surgery/follow-up, laser surgery for a brain tumor, and many other complex procedures. Our corporate rate was never increased as a result of individual spending.
posted by Oriole Adams at 1:49 PM on October 8, 2011 [1 favorite]

If you are dealing with hospital based or hospital associated physicians, they probably have financial counselors that can research your coverage, get estimates of treatment costs, estimate out of pocket costs, and help arrange payment plans. Divorce probably is not the best option, and in my state since there is a child involved it would take at least six months, which means you may be finished with treatments before your solution would be put into effect.
posted by Apoch at 1:57 PM on October 8, 2011 [1 favorite]

Oh, and also -- on the off-chance that it would somehow be better financially for you to be on your own insurance, you don't have to get a divorce to accomplish that. Your husband can simply drop you from his coverage at work while continuing to cover your daughter during the annual "open enrollment" period that all companies have (usually at the end of the calendar year). But again, don't do that until you have a much clearer sense of the nuts and bolts of both your insurance coverage and your health condition and all the options facing you.
posted by scody at 2:09 PM on October 8, 2011 [2 favorites]

I agree that the OP could get her own insurance, and I agree that it's more than likely she won't need to with the new "no max" laws in place, but if she's thinking more along the lines of qualifying for government aid, like disability or Medicaid, there's a possibility that a divorce could help not drag the whole family into bankruptcy, if that's a risk. She should talk to a professional about that- government aid has look-back periods and I don't know how they work wrt divorces.
posted by small_ruminant at 2:20 PM on October 8, 2011

This is getting close to being an AskMe cliche, but OP, please consult an estate-planning lawyer. Even if some of the posters above-thread are correct and your insurance doesn't "max out" after an expensive treatment, there may be asset-protection steps that can be taken to protect your husband's assets (and even your other family assets) from creditors, medical or otherwise. What makes sense will depend on the amount of your current assets, your time horizons and the individual law of your jurisdiction.

More importantly, if you are faced with that kind of diagnosis, making sure that your estate planning documents accurately reflect your intent regarding who cares for your daughter, etc. is really important.
posted by QuantumMeruit at 2:36 PM on October 8, 2011 [2 favorites]

I bought self-pay insurance for myself [...] I agree that the OP could get her own insurance

The cost of insuring yourself if you have cancer would be truly astronomical. I do not think it a realistic option unless the OP has so much money that she shouldn't be asking this question in the first place.
posted by Justinian at 2:44 PM on October 8, 2011 [5 favorites]

(uh, I'm referring to private plans. Plans provided by the state may be fixed cost).
posted by Justinian at 2:45 PM on October 8, 2011

State insurance is not the "entitlement" bonanza tea partiers would have you believe....going on Medicaid might knock you to the bottom of months long wait lists, or driving hours to see someone who takes it. That's when shit gets real. We already ration care.
posted by availablelight at 3:23 PM on October 8, 2011 [3 favorites]

Don't assume that health care coverage on your own would be astronomical. (mine is not) (Suggesting a possibility you could get insured on your own without getting divorced)

What if you found a gay marriage message board or gay rights message board - where people discuss these kinds of issues all the time (not being allowed to be married and how that affects work benefits). [I assume boards like this exist - help me out Mefites]
posted by cda at 3:36 PM on October 8, 2011

And call Blue Cross in another city anonymously from a pay phone and ask them directly what could happen.
posted by cda at 11:07 AM on October 9, 2011