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State continuation for age 55+ upon divorce or legal separation

State Continuation of Group Health Coverage Ending Due to Marriage Dissolution or Divorce for Persons Age 55 or Older

This provision applies only if your coverage is provided through an employer who employs 20 or more employees or if your coverage is provided by a group health insurance plan that covers 20 or more employees. Federal law, commonly known as COBRA, may also enable you to continue coverage.

State continuation is also available for persons covered by smaller employers (fewer than 20 employees). For information about that state continuation provision, please see the information posted here: State continuation

If you are a divorced or legally separated spouse and if you are 55 years of age or older when the dissolution or legal separation occurs, you may continue your existing group coverage until you obtain other group coverage or become eligible for Medicare.

In order to continue coverage, you must do both of the following:

  1. You must notify the group health insurance plan administrator in writing of the dissolution or legal separation within 60 days of the entry of the decree of divorce or legal separation.
  2. You must elect to continue and pay for the group coverage. You must make the election on a form provided by the plan administrator.

Another option is to purchase individual coverage through HealthCare.gov.

If you buy a plan through HealthCare.gov, you may qualify for help paying for your individual or family coverage.

You may apply for coverage through the HealthCare.gov up to 60 days prior to loss of coverage, or within 60 days after losing coverage.

Begin at OregonHealthCare.gov, the website for the Oregon Health Insurance Marketplace. The Marketplace is part of DCBS and helps Oregonians get covered at HealthCare.gov. Use the tools at OregonHealthCare.gov to get directed to the right application for you, or to find free, local help from an enrollment expert.

If you apply at HealthCare.gov and make your plan selection before your coverage ends or within the same month that your coverage ends, your new coverage will be effective the 1st day of the month following the end of coverage.

If you do not enroll within 60 days after coverage ends, you must wait until the next open enrollment period to buy an individual health plan. During open enrollment, if you enroll in a plan through the Marketplace between the 1st and the 15th of the month, your coverage will begin the first of the following month. If you enroll in a plan through the Marketplace between the 16th and the end of the month, your coverage will not begin until the first of the second month following your enrollment.

You may also use HealthCare.gov ’s financial help calculator to estimate your eligibility for help paying for coverage and the amount of assistance you may receive. You will need to complete an application to receive a full eligibility determination and actual amount of assistance.

If you are interested in purchasing new health insurance coverage (either from us or another insurance company) through HealthCare.gov, begin at OregonHealthCare.gov , a DCBS website with information that helps Oregonians get covered.

You may also visit HealthCare.gov directly, or contact their customer service center at 1 -800-318-2596 (Telecommunications Relay Service: 711 or call TTY 1-855-889-4325.)

Some people will qualify for no-cost coverage through the Oregon Health Plan (Medicaid)

Answer the questions under “Get Covered” at OregonHealthCare.gov to learn if you should begin an insurance application for the Oregon Health Plan. Eligibility for the Oregon Health Plan is based mostly on income and household size. Immigration status is also a factor for adults.

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