Medicare Blog

will my aca go up when spouse goes on medicare

by Aurore Stokes Published 2 years ago Updated 1 year ago
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Yes! If you worked and paid Medicare taxes through payroll deductions for at least 10 years, then you and your spouse will both for premium-free Medicare Part A at age 65. 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.

Full Answer

Is the ACA better than Medicare for my spouse?

The one plus is that your spouse will still use household income to determine subsidies. Thus, at some incomes this works out to a great deal (in my opinion better than Medicare cost-wise), but only at some incomes. I am preparing to retire. My spouse is 58. I have been checking locally for the ACA policies available.

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.

What happens to my ACA premium credit when Medicare Part A starts?

“Once your Medicare Part A coverage starts, you will no longer get premium credit through the ACA. If you continue to keep your marketplace health plan, you will have to pay the full cost.”

Can I get Medicare Part A if my spouse turns 65?

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 (if your spouse has worked and paid Medicare taxes for at least 10 years).

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What happens to my spouse when I go on 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.

Does spouse Social Security count as income for Obamacare?

Yes, Social Security benefits are counted as income in determining eligibility for premium tax credits in the Marketplace.

Can you have Medicare and ACA at the same time?

People having both Medicare parts, Part A and Part B, have coverage that is compliant with ACA requirements for the health plans. They don't need to enroll in additional health coverage, and they will not need to pay a penalty for lack of coverage.

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.

What happens to the ACA subsidy when one person goes on Medicare?

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).

Does Social Security affect Affordable Care Act?

Does Social Security Income Count As Income For Health Insurance Subsidies? Non-taxable Social Security benefits are counted as income for the Affordable Care Act and affect tax credits. This includes disability payments (SSDI), but does not include Supplemental Security Income.

Is Obamacare good for seniors?

Free Preventive Services and Annual Wellness Visit These include flu shots, mammograms, and tobacco use cessation counseling, as well as no-cost screenings for cancer, diabetes, and other chronic diseases. Seniors can also get a free annual wellness visit, so they can talk to their doctor about any health concerns.

Why do doctors not like Medicare Advantage plans?

If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

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.

Why is my wife's Medicare premium higher than mine?

Any changes in your Part B premiums are not related to your income but to your individual Social Security benefits. Any changes in your Part B premiums are not related to your income but to your individual Social Security benefits.

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 can you keep cobra?

In most cases, COBRA allows you to continue coverage for 18 months. But if your spouse became eligible for Medicare and then left his or her employment (and thus lost access to employer-sponsored coverage) within 18 months of becoming eligible for Medicare, you can continue your spousal coverage with COBRA for up to 36 months from ...

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.

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).

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.

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.

Who is Elizabeth Davis?

Elizabeth Davis, RN, is a health insurance expert and patient liaison. She's held board certifications in emergency nursing and infusion nursing. 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, ...

Who is Dale Brauner?

Dale is an experienced fact checker and researcher with a Master of Science in Journalism from Columbia University, Graduate School of Journalism. Learn about our editorial process. Dale Brauner. Updated on September 17, 2020. If your health insurance coverage comes through your spouse’s job, you may lose that coverage when he or she retires ...

Are there income limits for ACA subsidy eligibility?

Normally, subsidy eligibility only extends to households with income up to 400% of the poverty level, with no subsidies available for households with income above that point. But for 2021 and 2022, the American Rescue Plan has eliminated that income threshold.

Will we qualify for a subsidy?

The exchange will look to see what percentage of your total household income is necessary to cover the full-price cost of the benchmark plan for your wife. If it’s more than the percentage of income that people are expected to pay for their coverage, she’ll qualify for a premium subsidy.

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 happens if you don't sign up for Medicare?

And if you keep your individual market exchange plan and don’t sign up for Medicare when you first become eligible, you’ll have to pay higher Medicare Part B premiums for the rest of your life, once you do enroll in Medicare, due to the late enrollment penalty.

How long does it take to get Medicare if you are not receiving Social Security?

If you’re not yet receiving Social Security or Railroad Retirement benefits, you’ll have a seven-month window during which you can enroll in Medicare, which you’ll do through the Social Security Administration. Your Medicare card will be sent to you after you enroll. Your enrollment window starts three months before the month you turn 65, ...

When does Medicare coverage take effect?

If you complete the enrollment process during the three months prior to your 65th birthday, your Medicare coverage takes effect the first of the month you turn 65 ( unless your birthday is the first of the month ). Your premium subsidy eligibility continues through the last day of the month prior to the month you turn 65.

When does Medicare subsidy end?

If you enroll in Medicare during the final three months of your initial enrollment period, your premium subsidy will likely end before your Part B coverage begins, although your Part A coverage should be backdated to the month you turned 65.

When will Medicare be enrolled in Social Security?

Here are the details: If you’re already receiving retirement benefits from Social Security or the Railroad Retirement Board, you’ll automatically be enrolled in Medicare with an effective date of the first of the month that you turn 65. As is the case for people who enroll prior to the month they turn 65, premium subsidy eligibility ends on ...

When will Medicare be sent to you?

Your Medicare card will be sent to you after you enroll. Your enrollment window starts three months before the month you turn 65, includes the month you turn 65, and then continues for another three months. (Note that you’ll need to enroll during the months prior to your birth month in order to have coverage that takes effect the month you turn 65.

When do individual market plans end?

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).

When does Medicare pay late enrollment penalty?

If you enroll in Medicare after your Initial Enrollment Period ends, you may have to pay a Part B late enrollment penalty for as long as you have Medicare. In addition, you can enroll in Medicare Part B (and Part A if you have to pay a premium for it) only during the Medicare general enrollment period (from January 1 to March 31 each year).

When does Medicare enrollment end?

For most people, the Initial Enrollment Period starts 3 months before their 65th birthday and ends 3 months after their 65th birthday.

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