Medicare Blog

planning for health care when one spouse is eligible for medicare and the other is not

by Nicola Ferry Published 2 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.

Full Answer

Can my spouse and I have the same Medicare plan?

You and your spouse's Medicare coverage might not start at the same time. 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.

Can a non-working spouse get their own medicare plan?

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 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).

When does my spouse become eligible to receive Medicare?

If your spouse is younger than 65 and receives disability benefits from Social Security for a period of 24 months, they automatically become eligible for Medicare on the 25th month. What Happens if Your Spouse is Older Than You?

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.

Do both spouses have to be 65 for Medicare?

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.

Does marriage affect Medicare eligibility?

No, getting married does not affect your eligibility for Medicare or Social Security benefits. Any person who has paid into the Medicare system as part of their employment for the equivalent of 40 credits, or about 10 years, of work is eligible to receive full Medicare benefits at the age of 65.

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 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 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.

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 can I reduce my Medicare coverage?

Depending on the type of Medicare plan you are enrolled in, you could potentially lose your benefits for a number of reasons, such as:You no longer have a qualifying disability.You fail to pay your plan premiums.You move outside your plan's coverage area.Your plan is discontinued.More items...

Can I get AARP health insurance at 62?

Full AARP membership is available to anyone age 50 and over.

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.

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.

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 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 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 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.

Can my ex spouse get medicare?

Spouse & Ex-Spouse Eligibility for Medicare. There’s no family plan for Medicare; plans are individual. Meaning, your spouse’s eligibility may not match yours. For those currently married: Your spouse must be at least 65 years old, and you need to be married for at least a year.

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 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 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.

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.

What happens if you enroll in Medicare after the initial enrollment period?

Also, if you enroll in Medicare after your Initial Enrollment Period, you may have to pay a late enrollment penalty. It’s important to coordinate the date your Marketplace coverage ends with the effective date of your Medicare enrollment, to make sure you don’t have a break in coverage.

Why is it important to sign up for Medicare?

It’s important to sign up for Medicare when you’re first eligible because once your Medicare Part A coverage starts, you’ll have to pay full price for a Marketplace plan. This means you’ll no longer be eligible to use any premium tax credit or help with costs you might have been getting with your Marketplace plan.

Is it too soon to switch to Medicare if you turn 65?

If you have a health plan through the Health Insurance Marketplace® and will soon have Medicare eligibility, it’s not too soon to start planning for your coverage to switch.

Can I cancel my Medicare Marketplace coverage for myself?

If you and your spouse (or other household members) are enrolled on the same Marketplace plan, but you’re the only one eligible for Medicare, you’ll cancel Marketplace coverage for just yourself. This way any others on the Marketplace application can keep Marketplace coverage. Find out how here.

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