Medicare Blog

if your spouse receives medicare how can the rest of your family qualify

by Marvin Hessel Published 2 years ago Updated 1 year ago

Some spouses may qualify by reaching 65 years of age and having their own eligible work and tax record. Others, however, may not have worked for the required number of quarters. In these cases, Medicare can use the work record of a married enrollee to qualify their spouse for a plan.Apr 21, 2020

Can my spouse receive Medicare benefits if I am not retired?

If your spouse is older than you and not working when they turn 65, they may be eligible to receive Medicare benefits based on your work record even if you are not retired or receiving Medicare coverage yourself. In a case such as this, you must be at least 62 years old.

Can my family members qualify for Medicare?

Can my family members qualify for Medicare? En español | Generally, Medicare is for individuals and does not provide family coverage. However, under certain conditions, your spouse, divorced spouse, widow or widower, or a dependent parent may be eligible for hospital insurance when they turn 65, based on your work record.

When can my spouse enroll in Medicare?

If your spouse is at least 62 years old, and has worked at least 10 years paying Medicare taxes, you can enroll in Medicare when you turn 65, including premium-free Part A.

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.

Does Medicare cover the whole family?

Summary: Medicare is individual insurance, not family insurance, and coverage usually does not include spouses and children. Unlike other types of insurance, Medicare is not offered to your family or dependents once you enroll. To get Medicare, each person must qualify on their own.

Can one spouse be on Medicare and the other not?

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.

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.

Is my spouse eligible for Medicare when I turn 65?

Your spouse is eligible for Medicare when he or she turns 65. Your eligibility for Medicare has no impact on the date that your spouse is eligible for Medicare. Continue reading for more answers to your questions about Medicare, individual health insurance, and coverage options for your spouse after you enroll.

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. Traditional Medicare includes Part A (hospital insurance) and Part B (medical insurance).

Can I be covered under my husband's Medicare?

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. However, some spouses qualify based on the work record of their spouse or a former spouse.

Is my spouse eligible for Medicare if she never worked?

Can I Get Medicare If I've Never Worked? If you've never worked, you may still qualify for premium-free Medicare Part A. This is based on your spouse's work history or if you have certain medical conditions or disabilities. It's also possible to get Medicare coverage if you pay a monthly Part A premium.

Does getting married 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.

Does my spouse income affect my Medicare premiums?

No. Your eligibility for premium tax credit subsidies and the amount of your premium tax credit will be based on your family income. The amount your spouse pays for his Medicare, Part D, and supplemental insurance premium costs will not be taken into account.

What happens when my husband goes on Medicare?

Although your husband now qualifies for Medicare, you will not qualify for Medicare until you turn age 65. If you do not have health insurance now, you can consider signing up for health insurance coverage through a Marketplace plan.

Can you add your partner to your Medicare card?

On your homepage, select My card. You'll see your current Medicare card. Select Add someone to my card. You'll see information about how we can help people with family and domestic violence concerns.

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 old do you have to be to get Medicare?

If your spouse is at least 62 years old, and has worked at least 10 years paying Medicare taxes, you can enroll in Medicare when you turn 65, including premium-free Part A. If your spouse is younger than 62 when you turn 65, you won’t qualify for premium-free Part A until your spouse turns 62 ...

How long do you have to work to get Medicare?

Generally, you qualify for premium-free Part A when you’ve worked at least 10 years (40 quarters) paying Medicare taxes. Beneficiaries typically pay a Part B premium.

Do you have to pay Medicare premiums if you haven't worked?

Beneficiaries typically pay a Part B premium. If you haven’t worked and paid taxes for that long, you may have to pay a monthly premium for Medicare Part A, depending on your spouse’s age and how long he or she has worked and paid taxes. If you’re married and haven’t worked in a paying job:

What to do if you lost your spouse on Medicare?

It’s your responsibility to enroll in a new policy as soon as possible to ensure eligibility. If you recently lost a spouse and your Medicare policy, please call an agent at the number above to start discussing your options.

How old do you have to be to qualify for Medicare?

Qualifying for Medicare is different than Social Security benefits. You can be eligible for your spouse/ex-spouse Social Security benefits at age 62, and you won’t qualify for Medicare until age 65. Of course, you may be eligible for Medicare sooner if you have End-Stage Renal Disease or disability for at least two years.

Is there a family plan for Medicare?

There’s no family plan for Medicare; plans are individual. Meaning, your spouse’s eligibility may not match yours.

Can you lose Medicare if your spouse dies?

If you lose Medicare coverage due to the death of a spouse, you become eligible for a Special Election Period; but, that period doesn’t last forever.

How long do you have to work to get 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.

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.

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 have the same birthday?

While it would be convenient for spouses to have the exact same birthday, this is not usually the case. For many couples, their age gap becomes a problem when it comes time to sign up for Medicare. When one spouse goes on Medicare and the other spouse is not yet eligible, what options do they have?

How long do you have to pick a new insurance plan after losing your spouse's insurance?

Losing the coverage you had under your spouse's plan will make you eligible for a time-limited special enrollment period in the individual insurance market, on- or off-exchange (note that in this case, you have 60 days before the loss of coverage, and 60 days after the loss of coverage, during which you can pick a new plan).

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

If you’re not going to be eligible for Medicare yourself within 18 months (or up to 36 months, depending on the circumstances), you’ll have to come up with another plan for coverage when your COBRA continuation coverage runs out.

Is Medicaid a separate program from Medicare?

It’s easy to confuse Medicaid and Medicare, but they're separate programs with different benefits and different eligibility criteria. In many states, low-income people making up to 138% of federal poverty level are eligible for Medicaid.

Can you charge more for medical insurance?

Whether you buy a plan privately or on your state’s health insurance exchange, insurance companies are no longer allowed to charge you more for major medical health insurance because you have a preexisting condition or health problem (note that if you're buying coverage that isn't ACA-compliant, such as short-term insurance, your medical history will still be used to determine eligibility for coverage).

Does Wisconsin have Medicaid?

If you live in a state that chose not to expand its Medicaid rolls, the rules for Medicaid eligibility will be more complicated, and it's unlikely that you'll qualify unless you're low-income and also disabled or caring for a minor child (note that Wisconsin has not expanded Medicaid, but allows non-disabled adults with income up to 100 percent of the poverty level to enroll in Medicaid).

Can I get medicaid if my income is low?

If your income is low enough, you may be eligible for government-provided health insurance through Medicaid. In some states, the Medicaid program goes by another name like SoonerCare in Oklahoma or Medi-Cal in California. It’s easy to confuse Medicaid and Medicare, but they're separate programs with different benefits and different eligibility criteria.

How long do disabled widows have to be on Medicare?

Also, disabled widows and widowers under age 65, disabled divorced widows and widowers under 65, and disabled children may be eligible for Medicare, usually after a 24-month qualifying period.

Can a widow get medicare?

En español| Generally, Medicare is for individuals and does not provide family coverage. However, under certain conditions, your spouse, divorced spouse, widow or widower, or a dependent parent may be eligible for hospital insurance when they turn 65, based on your work record. Also, disabled widows and widowers under age 65, disabled divorced widows and widowers under 65, and disabled children may be eligible for Medicare, usually after a 24-month qualifying period.

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.

Is Medicare an individual insurance?

Medicare is an individual insurance system, but there are times when one spouse’s eligibility may help the other receive certain benefits.

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.

Why do Medicare premiums change?

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. Here's what to know about costs:

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.

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.

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