Can I Get Medicare Through My Spouse?

Many people are used to having an employer-sponsored health insurance plan that covers both them and their family. When they become eligible for Medicare, they assume it works the same way. So, it’s common for married seniors to ask if their Medicare plan can extend to their spouse.

However, Medicare is an individual insurance plan that does not work the way group plans do. Two people cannot be on a Medicare plan together — even if they both meet the eligibility requirements for Medicare.

Here’s what you need to know about Medicare and how married seniors can ensure they both get the coverage they need.

Medicare only covers one person at a time.

The most important thing to remember about Medicare is that plans are designed to cover one person at a time. This is true for both Original Medicare (Medicare Part A and Part B) and Medicare Advantage plans.

When you turn 65 and become eligible for Medicare, you are allowed to sign up for coverage for yourself only. If you are married, your spouse will need to wait to sign up until they become eligible for Medicare, then enroll themselves.

This means that married couples enrolling in Medicare will each be responsible for their own premiums and late enrollment penalties, if applicable.

Spouses may get premium-free Medicare Part A.

People who have worked and paid taxes for 10 years are usually eligible for premium-free Medicare Part A. If you have a non-working spouse, they may also be eligible for premium-free Part A when they turn 65. In order for your non-working, Medicare-eligible spouse to qualify to receive premium-free Part A, you need to be at least 62 or eligible to collect Social Security benefits.

How Medicare works with employer-sponsored insurance:

What happens when one person in a married couple is still working and becomes eligible for Medicare? If you and your spouse are covered by an employer-sponsored group health plan together and one of you becomes eligible for Medicare, you’ll need to plan carefully.

If your spouse is the policyholder for your group health plan and turns 65 before you do, you’ll need to discuss how you will access healthcare coverage until you become eligible for Medicare. Your spouse may remain enrolled in the group health plan and enroll in Medicare Part A and Part B simultaneously. This would allow you to remain on the employer insurance plan. If your spouse drops the group plan, you may purchase individual insurance until you turn 65. You might also be offered COBRA coverage if your spouse retires. Regardless of what you choose, you may not enroll in Medicare alongside your spouse until you are 65.

If your spouse is the policyholder for an employer-sponsored group health plan and you turn 65 first, you’ll need to enroll in at least Medicare Part A. You may delay enrollment in Part B until your spouse loses their group plan coverage. In this case, the Part B late enrollment penalty won’t apply to you, and you can enroll in Part B during a Special Enrollment Period.

It’s important to discuss your plans with your spouse’s employer, since they may have rules that require covered dependents to enroll in Medicare in order to stay on the group plan.

Plan for your family’s healthcare coverage.

If you or your spouse are approaching the age of eligibility for Medicare, it’s time to start planning what your healthcare coverage will look like. Begin exploring Medicare plan options and contact your employer if you’re still working to ensure you’ll both retain the benefits you need.

Do you have questions about Medicare? Reach out to PlanEnroll and let us help.

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