Medicare Blog

what is eligibility for medicare as spouses benefit

by Linwood Wisozk Published 2 years ago Updated 1 year ago
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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.

Full Answer

What qualifies a spouse for Medicare?

What it means to pay primary/secondary

  • 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.

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Do I qualify for subsidies if spouse has Medicare?

No, as long as the coverage qualifies as “ affordable ” under the Affordable Care Act. Your spouse and dependents must get individual coverage, but they aren’t eligible for the tax subsidy. According to the Affordable Care Act, coverage is affordable if it costs 9.5 percent or less of your earned wages.

Do Your Medicare benefits cover your spouse?

Your personal Medicare insurance policy does not cover anyone but you. Your spouse or family members cannot be included in your coverage. For your spouse to have Medicare coverage, he or she must have a separate, individual policy.

Do I get the same Medicare benefits as my spouse?

You cannot be on the same Medicare Supplement insurance policy as your husband or wife you must have separate policies. However, you and your spouse may be able to get a discount if you both buy individual policies from the same insurance company. In 2021, most enrollees pay $148.50/month for their Part B coverage, which is the standard amount.

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Is a spouse eligible for Medicare?

Anyone who meets Medicare eligibility requirements can get Medicare, including spouses.

Can my spouse get Medicare if I am 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.

Can my wife get 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.

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 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.

Do I automatically get Medicare when I turn 65?

You automatically get Medicare when you turn 65 Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

What are spousal benefits?

Spousal benefits are Social Security benefits that are based on your spouse's work record instead of your own. In some circumstances, you're eligible for spousal benefits even if you've divorced. Your Social Security retirement benefit is typically based on your 35 highest-earning years of work.

What are the rules for spousal benefits of Social Security?

To qualify for spouse's benefits, you must be one of these: At least 62 years of age. Any age and caring for a child entitled to receive benefits on your spouse's record and who is younger than age 16 or disabled.

What are the qualifications for Medicare?

Medicare is health insurance for people 65 or older. You're first eligible to sign up for Medicare 3 months before you turn 65. You may be eligible to get Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig's disease).

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.

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.

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.

How long does Cobra last?

Usually, COBRA coverage comes into effect for a maximum of 18 months, but in some situations, the younger spouse may receive such coverage for a longer period. If the younger spouse becomes eligible for Medicare during this period, their COBRA benefits will end.

How many credits do you need to be self employed to qualify for Medicare?

Anyone born after 1929 must have a minimum of 40 work credits, or have 10 years’ worth of credits, to become eligible for Medicare . People born before this require fewer credits.

How many credits do you need to get Social Security?

A person who develops a disability between 31–42 years of age will require 20 work credits for Social Security disability benefits.

Can a spouse be eligible for Medicare?

A person may qualify for Medicare based on the work record of their spouse. The spouse of a Medicare plan holder becomes eligible for their own plan upon turning 65 years of age, even if they never worked outside the home. The spouse qualifies based on their spouse’s work record. If a spouse has a disability, they may qualify at a younger age.

Does Medicare cover spouses?

Medicare does not cover spouses specifically. However, some spouses qualify based on the work record of their spouse or a former spouse. 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.

Can an older spouse retire with Medicare?

However, in most circumstances, they would not be eligible for Medicare coverage until they reach the eligible age.

Can a domestic partner enroll in Medicare without a penalty?

Unlike a spouse, a domestic partner cannot take advantage of waiting to enroll in Medicare Part B without paying a late enrollment penalty, and there are no special enrollment periods (SEP) for unmarried domestic partners.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

Who is Lindsay Malzone?

https://www.medicarefaq.com/. Lindsay Malzone is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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.

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.

Who is Christian Worstell?

Christian Worstell is a licensed insurance agent and a Senior Staff Writer for MedicareAdvantage.com. He is passionate about helping people navigate the complexities of Medicare and understand their coverage options. .. Read full bio

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 ...

What happens if you take your reduced retirement first?

If you took your reduced retirement first while waiting for your spouse to reach retirement age, when you add spouse’s benefits later, your own retirement portion remains reduced which causes the total retirement and spouses benefit together to total less than 50 percent of the worker’s amount. You can find out more on our website.

What is the maximum survivor benefit?

The retirement insurance benefit limit is the maximum survivor benefit you may receive. Generally, the limit is the higher of: The reduced monthly retirement benefit to which the deceased spouse would have been entitled if they had lived, or.

How much of my spouse's retirement is my full benefit?

Your full spouse’s benefit could be up to 50 percent of your spouse’s full retirement age amount if you are full retirement age when you take it. If you qualify for your own retirement benefit and a spouse’s benefit, we always pay your own benefit first. You cannot receive spouse’s benefits unless your spouse is receiving his or her retirement ...

What does it mean to have a partner?

Having a partner means sharing many things including a home and other property. Understanding how your future retirement might affect your spouse is important. When you’re planning for your fun and vibrant golden years, here are a few things to remember:

Can my spouse's survivor benefit be reduced?

On the other hand, if your spouse’s retirement benefit is higher than your retirement benefit, and he or she chooses to take reduced benefits and dies first, your survivor benefit will be reduced, but may be higher than what your spouse received.

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.

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What happens if your spouse's retirement benefits are higher than your own?

If your benefits as a spouse are higher than your own retirement benefits, you will get a combination of benefits equaling the higher spouse benefit. Here is an example: Mary Ann qualifies for a retirement benefit of $250 and a spouse’s benefit of $400.

When will my spouse receive my full retirement?

You will receive your full spouse’s benefit amount if you wait until you reach full retirement age to begin receiving benefits. You will also receive the full amount if you are caring for a child entitled to receive benefits on your spouse’s record who is younger than age 16 or disabled.

How old do you have to be to get spouse's Social Security?

To qualify for spouse’s benefits, you must be one of these: At least 62 years of age.

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.

What is Cobra insurance?

COBRA, or the Consolidated Omnibus Budget Reconciliation Act, is a law that gives workers and families that lose employer health coverage the right to maintain the coverage by paying the full premiums. If a company has more than 20 employees, it is required to offer COBRA benefits. COBRA allows coverage for 18 months, sometimes longer, ...

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.

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?

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.

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