Medicare Blog

how does medicare work for a spouse who:does not have enough quarters but the other spouse does

by Valentin Shanahan II Published 1 year ago Updated 1 year ago

If you do not have at least 40 calendar quarters of work during which you paid Social Security taxes in the U.S., but your spouse does, you may be eligible for premium -free Medicare Part A based on your spouse’s work history when you turn 65.

If you do not have at least 40 calendar quarters of work during which you paid Social Security taxes in the U.S., but your spouse does, you may be eligible for premium-free Medicare Part A based on your spouse's work history when you turn 65.

Full Answer

How does Medicare work with my spouse?

Most considerations for Medicare and spouses are surrounding Medicare Part A, which is the insurance portion that covers hospital visits. The other portions are available when an individual turns age 65 and agrees to pay the insurance premium.

Do I qualify for Medicare if my spouse doesn’t work?

If a person’s spouse didn’t work, they may still qualify for Medicare Part A based on their spouse’s work history when they turn age 65. To qualify for Medicare Part A benefits at age 65 based on your spouse’s work history, you must meet one of the following requirements:

Can I enroll in Medicare Part A under my spouse's work history?

However, you can enroll in premium-free Part A under your spouse’s work history if he or she has the necessary 40 quarters of Medicare earnings required, is at least age 62, and you have been married at least 1 year. NOTE: Your spouse does NOT have to be receiving Social Security retirement benefits for this to work.

Does Medicare cover my spouse if I turn 62?

Once you turn 62 (and if you paid at least 10 years of Medicare taxes), your spouse will then be able to receive premium-free Part A. *You must be married for at least one year before an older spouse can be eligible for Medicare based on your work record. Do other parts of Medicare cover spouses?

Can one spouse be on Medicare and the other not?

But when a person asks “Can my non-working spouse get Medicare?” they really are asking “Can my spouse be on my Medicare plan?” The answer is no. Medicare is individual insurance, so spouses cannot be on the same Medicare plan together.

Is my spouse eligible for Medicare if she never worked?

A non-working spouse can receive premium-free Medicare part A as long as the other partner is at least 62 years old and has satisfied Medicare's work requirements. For example, John is 65 years old and has never worked or paid Medicare taxes.

How does Medicare work for married couples?

Medicare has no family plans, meaning that you and your spouse must enroll for Medicare benefits separately. This also means husbands, wives, spouses and partners pay separate Medicare premiums.

Does spouse's income affect Medicare?

The good news about marriage and Medicare is that your coverage won't change. Neither will your spouse's. Whether you're already married, thinking about getting married, or no longer married, here's what you need to know.

Can you receive Medicare if you have never worked?

You can still get Medicare if you never worked, but it will likely be more expensive. Unless you worked and paid Medicare taxes for 10 years — also measured as 40 quarters — you will have to pay a monthly premium for Part A. This may differ depending on your spouse or if you spent some time in the workforce.

When I go on Medicare is my spouse covered?

Does Medicare cover people's spouses? Medicare offers federal health insurance coverage for those aged 65 years and over, as well as those with a permanent disability. Medicare does not cover spouses specifically.

Should my husband and I be on the same Medicare card?

Each family member has their name on their card , it is therefore an individual card eg I cannot use a card that has my husband's or any of my sons' names on it. I went to the Medicare office and they say that having same card or different card does not matter.

Is Medicare premium based on joint income?

Medicare premiums are based on your modified adjusted gross income, or MAGI. That's your total adjusted gross income plus tax-exempt interest, as gleaned from the most recent tax data Social Security has from the IRS.

Why is my Medicare premium more than my husbands?

If you file your taxes as “married, filing jointly” and your MAGI is greater than $170,000, you'll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status, and your MAGI is greater than $85,000, you'll pay higher premiums.

Can my wife get Medicare when I turn 65?

Traditional Medicare includes Part A (hospital insurance) and Part B (medical insurance). To qualify for Medicare, your spouse must be age 65 or older. If your spouse is age 62 (or any age under 65), he or she could only qualify for Medicare by disability.

What income is used to determine Medicare premiums?

modified adjusted gross incomeMedicare uses the modified adjusted gross income reported on your IRS tax return from 2 years ago. This is the most recent tax return information provided to Social Security by the IRS.

When can a spouse claim spousal benefits?

You must have been married at least 10 years. You must have been divorced from the spouse for at least two consecutive years. You are unmarried. Your ex-spouse must be entitled to Social Security retirement or disability benefits.

How long do you have to work to qualify for Medicare?

In the United States, as soon as you turn 65 you are eligible for Medicare benefits if you are citizen or have been a legal resident for five years or more and have worked for at least 40 quarters (10 years) paying federal taxes.

How old do you have to be to get Medicare?

In a case such as this, you must be at least 62 years old.

Can you get Medicare at different ages?

If you and your spouse are different ages, you will likely become eligible at different times. Primary Medicare recipients and their non-insured spouses are entitled to the same benefits under Medicare if both have reached the age of 65.

Do you have to enroll in Medicare Part B or D?

If you wish to sign up for Medicare Part B (Medical Insurance), and/or Part D (prescription drug insurance), you must enroll separately during your initial enrollment period, Open Enrollment or during Special Enrollment Period to avoid paying late enrollment penalties.

When can a spouse receive Medicare?

Now let’s look at when your spouse is older than you and your spouse didn’t meet the 40 quarters requirement, but you do. When you turn age 62 and your spouse is age 65, your spouse can usually receive premium-free Medicare benefits.

How long do you have to be married to qualify for Medicare?

You have been married to your spouse who qualifies for Social Security benefits for at least 1 year before applying for Social Security benefits. You are divorced, but were married to a spouse for at least 10 years who qualifies for Social Security benefits. You must now be single to apply for Medicare benefits.

How to apply for Medicare Part A?

To qualify for Medicare Part A benefits at age 65 based on your spouse’s work history, you must meet one of the following requirements: 1 You have been married to your spouse who qualifies for Social Security benefits for at least 1 year before applying for Social Security benefits. 2 You are divorced, but were married to a spouse for at least 10 years who qualifies for Social Security benefits. You must now be single to apply for Medicare benefits. 3 You are widowed, but were married for at least 9 months before your spouse died, and they qualified for Social Security benefits. You must now be single.

How long does it take to get Medicare if you don't work?

Medicare is a benefit for individuals who worked and paid Social Security taxes for at least 40 quarters of work, which is roughly about 10 years. If a person’s spouse didn’t work, they may still qualify for Medicare Part A based on their spouse’s work history when they turn age 65.

What is the number to call for Medicare?

If you have further questions about Medicare benefits, you can call the Social Security Administration (SSA) at 800-772-1213 or visit your local SSA office for more information. Read this article in Spanish.

What is Medicare Advantage?

One of these options is Medicare Advantage (Part C), which bundles both Part A and Part B together and offers additional coverage and benefits. If extra coverage, like dental, vision, or hearing care, is important to maintaining your individual health, give some thought to whether original Medicare or Medicare Advantage will work best for you.

Does Medicare affect spouse's health insurance?

Medicare is an individual insurance system, but there are times when one spouse s eligibility may help the other receive certain benefits. Also, the amount of money you and your spouse make combined may affect your Medicare Part B insurance premiums.

How long does a non-working spouse have to pay Medicare?

All of the following scenarios assume the non-working spouse has not paid Medicare taxes for 40 quarters (ten years) in their lifetime.

How long do you have to be married to get Medicare?

*You must be married for at least one year before an older spouse can be eligible for Medicare based on your work record.

What are the benefits of Medicare Advantage?

Some Medicare Advantage plans may also offer additional benefits such as prescription drug coverage and coverage for dental, vision and hearing care. To learn more about Medicare Advantage plans for you and your spouse, call to speak with a licensed insurance agent today.

Can a non-working spouse be covered by Medicare?

It isn’ t uncommon for a non-working person to be covered under their spouse’s health insurance plan. And Medicare coverage is no different in that regard. While there are of course some exceptions and special circumstances that apply, Medicare can and does provide coverage for the spouse of a beneficiary, even if that person does not qualify ...

How old do you have to be to get Medicare Part A?

You must be at least 62 years old and eligible for Social Security benefits before your spouse can enroll, because his or her qualification is based on your work record.

Why is there no Medicare premium?

There’s no premium for it because your Medicare tax dollars go into the hospital insurance trust fund, which then finances Medicare Part A benefits for eligible individuals.

What is Medicare Made Clear?

Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.

What happens if you have both health insurance and one turns 65?

If you both are covered by your employer health insurance, and one of you turns 65, you’ll have decisions to make about Medicare. In this case, it will depend on the employer and their rules around covered dependents of Medicare age.

Can my spouse get cobra insurance?

Your employer may offer COBRA coverage for your spouse if you retire. Your spouse may choose to buy individual health insurance until he or she turns 65.

Can a spouse and spouse have Medicare?

The answer is no. Medicare is individual insurance, so spouses cannot be on the same Medicare plan together. Now, if your spouse is eligible for Medicare, then he or she can get their own Medicare plan. But, what’s interesting is that there are some things to think about in regards to your non-working spouse and Medicare.

What happens if you don't have 40 quarters of work?

If you don’t have at least 40 quarters (about 10 years of work) paid into the Medicare system, you aren’t eligible for premium-free Medicare Part A. That means Part A is very expensive when you have limited or no work history.

How to enroll in Social Security by phone?

Enroll By Phone. Contact Social Security to schedule a phone appointment for this enrollment. You can call the main line at 800-772-1213 or a local Social Security office to schedule ( Social Security office locator ). We recommend initiating the request 3-4 months prior to your planned start date.

How long do you have to be married to get Medicare?

If you are currently married and your spouse qualifies for social security benefits and Medicare Part A premiums, you can apply as long as you have been married for at least a year prior to submitting the application. If you are divorced, you may be eligible if your former spouse is, as long as you were married for at least ten years.

How old do you have to be to get Medicare Part A?

In order to get these benefits, you must be at least 65 years of age and a United States citizen or a legal resident in the United States for a minimum of five years.

How long do you have to be married to qualify for a divorce?

If you are divorced, you may be eligible if your former spouse is, as long as you were married for at least ten years. You must also be currently single. You can also qualify if your spouse has passed away. You must have been married for at least nine months before the death of your spouse and you must be single.

How much is the 2020 Medicare premium?

If you have more than 30 credits, but less than 40 credits, you will be able to pay a slightly smaller amount at around $252.00 ( per 2020 costs ). You also have the option to continue working after you reach the age of 65 until you have earned the necessary 40 credits, in which case you will qualify for the free premium ...

How long do you have to be married to get Social Security?

You must have been married for at least one year before applying. You are divorced and your former spouse is eligible for Social Security benefits (either retirement or disability). You must have been married for at least 10 years, and you must now be single.

Can I get Social Security Disability if I have a spouse?

Note, however, that if you develop a disability before you turn 65, and do not have enough work history, you cannot qualify for Social Security Disability ( SSDI) based on your spouse’s work history. When you turn 65, you may be eligible for premium-free Part A based on your spouse’s work history if: You are currently married and your spouse is ...

How long do you have to work to qualify for Medicare?

First, it is important to know how eligibility for Medicare works. Most Medicare beneficiaries have worked and paid Medicare payroll taxes for at least 10 years to qualify for premium-free Medicare Part A as well as Part B coverage. If you have not worked for 10 years but your spouse has, you are allowed to claim benefits on their record. Medicare benefits cannot start earlier than when you turn 65, unless you are disabled, have ALS, or have end-stage renal disease. Medicare will only cover you, not your spouse or children if they are not eligible on their own.

How long does a spouse have to be on Cobra?

If a company has more than 20 employees, it is required to offer COBRA benefits. COBRA allows coverage for 18 months, sometimes longer, so if the working spouse can wait to retire until 18 months before the younger spouses 65th birthday, this would work out nicely.

Can a non-working spouse get Social Security?

If the non-working spouse is older than the working spouse, the non-working spouse can qualify on on the working spouses work record if they are at least 62, since that is when qualification for Social Security begins. In this case, if the working spouse is still working, the non-working spouse should stay on the work health insurance ...

Can a spouse get health insurance after 65?

The other option would be for the younger spouse to find a job that offers health insurance until they turn 65. While this is a long-shot, some companies will provide coverage for the younger spouse even after the working spouse retires.

Can a non-working spouse claim Medicare?

If the working spouse is no longer employed, the non-working spouse should go ahead and apply for coverage fully from Medicare. If the working spouse is younger than 62, the non-working spouse will not be able to claim on the record.

Does Medicare cover spouse?

Medicare will only cover you, not your spouse or children if they are not eligible on their own. This is where problems begin, especially when a working spouse is older than a non-working spouse. Say the working spouse turns 65, retires, and claims Medicare. The other spouse is only 61.

Can a spouse with a low income get medicaid?

Medicaid is a joint Federal and State program designed to help people with low incomes cover healthcare costs. If, by retiring, your income falls under a certain level, the younger spouse may be eligible for Medicaid coverage. Be aware, as a family, you have to have a very low income and very little assets, so many people will not qualify.

Enrolling in Medicare at 65

If you want to enroll when you are turning 65, you can enroll in Medicare Parts A & B, Part D prescription drug coverage or a Medicare Advantage (Part C) plan. You can also look at adding a Medicare supplement insurance plan to Original Medicare (Parts A & B) to help with the out-of-pocket costs of Medicare.

Enrolling in Medicare Part A at 65

Many people who are covered by a spouse’s employer plan choose to either wait to enroll until they lose their spouse’s employer coverage or choose to only enroll in Part A since Part A usually has no premium.

Delaying Medicare Enrollment

Just because you are turning 65, doesn’t necessarily mean you have to get Medicare right now. If you decide that waiting to enroll in Medicare is the best option both financially and in terms of healthcare coverage for you, just follow Medicare’s rules, and you’ll avoid enrollment penalties when you do enroll.

When Would I Enroll If I Delay or Only Take Part A?

If you are able to delay enrolling in either all or part of Medicare, you will have a Special Enrollment Period of eight months that begins when the employer coverage is lost or when your spouse retires. During this time, you’ll be able to enroll in Medicare Parts A & B. You can also enroll in a Part D prescription drug plan.

Medicare Made Clear

Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.

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