Medicare Blog

if my husband is eligible for medicare what happens to my health insurance

by Jamey Bayer Published 3 years ago Updated 2 years ago

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.

Your spouse can switch to health insurance from his or her employer until reaching Medicare age or beyond. Your spouse can qualify for a special enrollment period to switch to this coverage within 30 days of losing coverage under your plan or can enroll during the company's annual open enrollment period.

Full Answer

What happens to my health insurance when my spouse goes on Medicare?

If your health insurance coverage comes through your spouse’s job, you may lose that coverage when he or she retires and goes on Medicare. Not so long ago, this was a scary and expensive prospect, but things have changed.

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:

What do I need to know about Medicare if I'm already married?

Whether you're already married, thinking about getting married, or no longer married, here's what you need to know. You and your spouse's Medicare coverage might not start at the same time. Medicare is an individual plan (there is no family plan).

Can I get Medicare benefits if my spouse is older than me?

If your spouse is older than you, they’ll qualify for Medicare benefits at age 65. You may be able to receive Medicare benefits slightly earlier if you’re at least 62 years old, married to someone who is age 65, and also worked for 40 quarters and you paid Medicare taxes.

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.

What happens when one spouse goes on Medicare and the other isn't eligible?

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.

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.

What happens to my wife when I go on Medicare?

Your Medicare insurance doesn't cover your spouse – no matter whether your spouse is 62, 65, or any age. But in some cases, a younger spouse can help you get Medicare Part A with no monthly premium.

Do spouses get Medicare benefits?

When you turn age 62 and your spouse is age 65, your spouse can usually receive premium-free Medicare benefits. Until you're age 62, your spouse can receive Medicare Part A, but will have to pay the premiums if they don't meet the 40 quarters of work requirement.

What happens to a couples premium with one turning 65 and on the Affordable Care Act with a subsidy?

Individual market plans no longer terminate automatically when you turn 65. You can keep your individual market plan, but premium subsidies will terminate when you become eligible for premium-free Medicare Part A (there is some flexibility here, and the date the subsidy terminates will depend on when you enroll).

Do husband and wife pay same Medicare premiums?

There are no family plans or special rates for couples in Medicare. You will each pay the same premium amount that individuals pay. Here's what to know about costs: Medicare Part A, hospital coverage, has no monthly cost for most people who worked or have a spouse who worked and is eligible for Social Security.

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.

Can a husband and wife be on the same Medicare Advantage plan?

Medicare Advantage: what about my spouse? Medicare Advantage plans don't cover both you and your spouse together under one policy. Just as Medicare Part A and Part B cover each Medicare beneficiary separately, you can't share a Medicare Advantage plan with your spouse.

Why is my Medicare premium higher 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.

How much does Medicare cost at age 62?

Reaching age 62 can affect your spouse's Medicare premiums He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.

How do I apply for spousal Medicare benefits?

Form SSA-2 | Information You Need to Apply for Spouse's or Divorced Spouse's Benefits. You can apply: Online, if you are within 3 months of age 62 or older, or. By calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or visiting your local Social Security office.

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 Healthline Media offer insurance?

Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance. Last medically reviewed on December 20, 2019.

How old do you have to be to get Medicare?

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

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.

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.

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

If divorced, you must have been married for at least 10 years. Once you turn 65, you are eligible for free Medicare Part A through your former spouse, as long as they worked at least 10 years and paid Medicare taxes during that time.

How much does Medicare pay in 2021?

Most people pay the standard premium, which is $148 per month in 2021. The more you make each year, the more you'll pay each month for Medicare.

What is Medicare Advantage Plan?

A Medicare Advantage plan is a type of plan offered by a private insurance company to provide you with all your Medicare Part A and Part B services. You may be charged a separate premium by the insurance company in addition to your Part B premium and may be eligible for additional benefits, including prescription drugs.

Do you have to pay deductibles for Medicare Part D?

Even if you and your spouse pick the same plan, you'll each have to meet the deductible before Medicare starts to pay anything toward your health care.

Can you sign up for Medicare separately?

Since you each must enroll in Medicare separately, one of you may be able to sign up before the other one, depending on your age. Your premiums may change because of your total income. There are no family plans or special rates for couples in Medicare. You will each pay the same premium amount that individuals pay.

Does Medicare coverage change if you are married?

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.

Does Medicare Part A have monthly premiums?

You will each pay the same premium amount that individuals pay. Here's what to know about costs: Medicare Part A, hospital coverage, has no monthly cost for most people who worked or have a spouse who worked and is eligible for Social Security. The other parts of Medicare do have premiums.

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.

Medicare Made Clear

Whether you're just starting out with Medicare, need to brush up on the facts, or are helping a loved one, start your journey here.

How many employees does a spouse have to have to be on Medicare?

Your spouse’s employer must have 20 or more employees, unless the employer has less than 20 employees, but is part of a multi-employer plan or multiple employer plan. If the group health plan didn’t pay all of your bill, the doctor or health care provider should send the bill to Medicare for secondary payment.

How does Medicare work with other insurance?

When there's more than one payer, "coordination of benefits" rules decide which one pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" (supplemental payer) ...

How long does it take for Medicare to pay a claim?

If the insurance company doesn't pay the claim promptly (usually within 120 days), your doctor or other provider may bill Medicare. Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should have made. If Medicare makes a. conditional payment.

What is a group health plan?

If the. group health plan. In general, a health plan offered by an employer or employee organization that provides health coverage to employees and their families.

What is the difference between primary and secondary insurance?

The insurance that pays first (primary payer) pays up to the limits of its coverage. The one that pays second (secondary payer) only pays if there are costs the primary insurer didn't cover. The secondary payer (which may be Medicare) may not pay all the uncovered costs.

When does Medicare pay for COBRA?

When you’re eligible for or entitled to Medicare due to End-Stage Renal Disease (ESRD), during a coordination period of up to 30 months, COBRA pays first. Medicare pays second, to the extent COBRA coverage overlaps the first 30 months of Medicare eligibility or entitlement based on ESRD.

What is the phone number for Medicare?

It may include the rules about who pays first. You can also call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627).

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.

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.

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.

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.

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.

Do I need to sign up for Medicare when I turn 65?

It depends on how you get your health insurance now and the number of employees that are in the company where you (or your spouse) work.

How does Medicare work with my job-based health insurance?

Most people qualify to get Part A without paying a monthly premium. If you qualify, you can sign up for Part A coverage starting 3 months before you turn 65 and any time after you turn 65 — Part A coverage starts up to 6 months back from when you sign up or apply to get benefits from Social Security (or the Railroad Retirement Board).

Do I need to get Medicare drug coverage (Part D)?

You can get Medicare drug coverage once you sign up for either Part A or Part B. You can join a Medicare drug plan or Medicare Advantage Plan with drug coverage anytime while you have job-based health insurance, and up to 2 months after you lose that insurance.

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