Thursday February 22, 2024
Medicare Spousal Coverage
Many couples find themselves in a similar situation when applying for Medicare. In most cases, your spouse can generally qualify for Medicare on your work record. Here is how it works.
Medicare is a government health insurance program for older adults and covers around 60 million Americans age 65 and older. It also covers younger individuals that have a qualifying disability or have End-Stage Renal Disease.
To be eligible, you must have worked and paid Medicare taxes for at least 10 years to qualify for premium-free Medicare Part A hospital coverage when you turn 65. If you qualify, your non-working spouse will also qualify based on your work record when they turn 65.
Divorced spouses are also eligible if your marriage lasted at least 10 years, the divorced spouse is unmarried, they are age 62 or older, you qualify for Social Security or have a disability and the benefit they receive based on their own work is less than the benefit they would receive based on your work. Benefits are also available to surviving spouses who are single and who were married for at least nine months before their spouse passed away.
In addition to Part A, both you and your spouse would also qualify for Medicare Part B, which covers doctor’s visits and other outpatient services, but requires a monthly premium. The premium for Part B beneficiaries in 2024 is $174.70 per month per person. Couples filing jointly with incomes over $206,000 per year pay more.
If your spouse is older than you, your spouse can qualify for Medicare based off of your work record at age 65, even if you are not receiving Medicare yourself, but you must be at least 62 years old. Additionally, you must have been married for at least one year for your spouse to be eligible for Medicare on your work record.
If you are still working and your spouse is covered by your employer’s health insurance, your spouse may want to enroll only in the premium-free Medicare Part A until you retire or your employer coverage ends. Part B and its premium can be added later without penalty as long as your employer’s group health plan is your “primary coverage.” Check with your employers’ human resources department to find more information on this. (Note: If your spouse is funding a health savings account, they may not want to enroll in Part A because your spouse will not be able to make contributions after enrolling).
If your spouse is younger than you, they will need health insurance until age 65 and becomes eligible for Medicare. This may be through the Health Insurance Marketplace (see healthcare.gov), or if you are still working, through COBRA (see dol.gov/general/topic/health-plans/cobra).
Other Medicare Choices
In addition to Medicare Part A and B, when you and your spouse become Medicare eligible, each of you will need to enroll in a Part D prescription drug plan if you do not have credible drug coverage from your employer or union. Additionally, you may want to purchase a Medicare supplemental (Medigap) policy to help pay for things that are not covered by Medicare such as copayments, coinsurance and deductibles. You may also want to consider an all-in-one Medicare Advantage plan.
For more information on Medicare choices and enrollment rules visit Medicare.gov or call 800-633-4227. You can also get help through your State Health Insurance Assistance Program which provides free Medicare counseling.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.