Medicare Coverage for Non-Working Spouses

Thu, Apr 21, 2016 @ 09:00 AM

Medicare Coverage for Non-Working Spouses

Posted by Medicare Made Clear

Medicare isn’t just for people who retire after many years of working. In fact anyone can get Medicare, as long as he or she is a U.S. citizen or a legal resident for at least five years and meets one or more of these eligibility requirements:

• Age 65 or older
• Under age 65 with a qualifying disability
• Have End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant)

Yet one common question is: Can my non-working spouse get Medicare? The short answer is: Yes, if he or she is eligible (see Medicare eligibility requirements above). But there’s more to it than that.
Employed individuals pay Medicare taxes through payroll deductions. You need to work and pay taxes for at least 10 years to qualify for premium-free Medicare Part A coverage (hospital insurance) when you turn 65. If you qualify, then your non-working spouse may qualify based on your work record when he or she turns 65, too. In addition, you both would qualify for Medicare Part B coverage (medical insurance). Each covered individual pays a monthly Part B premium to Medicare.
Of course, many spouses turn 65 at different times or even in different years. When one of you becomes eligible for Medicare before the other, what then?

If Your Non-Working Spouse is Younger

You should enroll in Medicare at age 65, whether or not you are still working. Additional decisions such as whether to enroll in just Part A or in both Part A and Part B will depend on your specific situation.
Until your spouse turns 65 and becomes eligible for Medicare, he or she will need other health insurance. This may be through your employer if you continue working. Some employers offer COBRA or other health insurance options for younger spouses of retired employees as well. Your health plan administrator can help you understand your spouse’s choices. Your spouse may also buy individual coverage through the Health Insurance Marketplace in your state until he or she turns 65.

If Your Non-Working Spouse is Older

Your older spouse may qualify for Medicare on your work record at age 65, even if you’re not getting Social Security or Medicare yourself—but only if you are at least 62 years old. That’s because you qualify for Social Security at age 62. You don’t have to actually file for Social Security benefits in order for your spouse to get Medicare; you just need to be old enough to file if you wanted to.
If your spouse is covered by your employer health insurance, he or she may want to enroll only in premium-free Medicare Part A until you retire or your employer coverage ends. Part B—along with its premium—can be added later without penalty as long as your employer coverage is creditable, which means the benefits have to be at least as good as what Medicare provides.
If your spouse is more than 3 years older than you, then he or she may buy Medicare Part A until you turn 62 and the premium-free benefit kicks in.

A Note About Part D

It’s important to pay attention to timing when first enrolling in a Part D prescription drug plan. You and your spouse must each enroll in a Part D plan during your individual Initial Enrollment Periods—or have other creditable drug coverage—to avoid paying a premium penalty later. If you have other coverage and decide to delay Part D enrollment, you must enroll in a Part D plan within 63 days of your other coverage ending to avoid the penalty.
For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.

Resources:

Medicare & You: Get the official U.S. government Medicare handbook.

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