Tuesday, November 22, 2022

Are Spouses Eligible For Medicare

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Medicare At Age 65 If Your Younger Spouse Is Still Working

Who Is Eligible for Medicare?

Do you have employer-based health insurance through your spouse? If so, you might want to delay enrollment in Medicare Part B when youre age 65.

You generally pay a monthly premium for Medicare Part B. Most people dont pay a Part A premium. So, if youre covered under your working spouses plan at age 65, you might want to save money by delaying Part B enrollment.

Check with your spouses health plan to make sure it will cover you, and ask how it works with Medicare.

When you qualify for Medicare at age 65, youd be wise to learn about Medicare so you can have the best possible coverage for you. Then, you can use that wisdom to help guide Medicare planning for your spouse. Read this article on planning and budgeting for Medicare.

You might already know that your Medicare at age 65 doesnt have to stop at Medicare Part A and Part B coverage. You have other Medicare coverage choices and you can compare plans. Type your zip code in the box on this page to start looking at plans in your area.

You and your spouse have to enroll in Medicare coverage separately.

Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealths Medicare related content is compliant with CMS regulations, you can rest assured youre getting accurate information so you can make the right decisions for your coverage. Read more to learn about our Compliance Program.

Find Plans in your area instantly!

Once I Switch To Medicare What Are My Spouses Coverage Options

After you enroll in Medicare, your spouse will need to find individual health insurance. This can be acquired through one of two ways:

For more information, you can attend one of our Retiring Before Age 65? Your Health Care Coverage Options webinars to learn about individual health insurance options. Our advisors will be live to answer your questions! Visit this page to sign up for a webinar.

How Medicare Works If Your Age 62 Spouse Is Still Working And Youre On Medicare

To qualify for Medicare, your spouse must be age 65 or older. If your spouse is age 62 , he or she could only qualify for Medicare by disability.

Heres an example of when a younger spouse whos not yet on Medicare might help you save money.

  • Suppose you reach age 65 and qualify for Medicare, but you havent worked long enough to qualify for premium-free Medicare Part A.
  • And suppose your younger spouse has worked at least 10 years while paying Medicare taxes. When your spouse turns 62, youll qualify for premium-free Part A. Your spouse wont qualify for Medicare until they turn 65, but their work record will help you save money by getting Part A with no monthly premium.

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How Much You Pay For Medicare Part A

Those who do have to pay a premium for Medicare Part A will pay up to $411 in 2016 each month. As mentioned above, 10 years or 40 quarters results in premium-free Part A for most beneficiaries, but those who havent worked 40 quarters may need to pay out of pocket for their Part A premiums.

  • People with 30 to 39 quarters of Medicare-covered employment pay a monthly premium of $226 in 2016.
  • Those with less than 30 quarters of Medicare-covered employment and who are not eligible for free or reduced Medicare premiums for any other reason pay a monthly premium of $411 in 2016.

Benefits For Your Divorced Spouse

Do I need Medicare if Im covered by my spouses employer plan?

If you are divorced, your ex-spouse can receive benefits based on your record if:

  • Your marriage lasted 10 years or longer.
  • Your ex-spouse is unmarried.
  • Your ex-spouse is age 62 or older.
  • The benefit that your ex-spouse is entitled to receive based on their own work is less than the benefit they would receive based on your work.
  • You are entitled to Social Security retirement or disability benefits.

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How Social Security And Medicare Taxes Are Calculated And Withheld Together As A Federal Tax

The taxes you pay while working that eventually qualify you for premium-free Medicare Part A come from the Federal Insurance Contributions Act . This tax law takes a percentage from paychecks and income, putting these subtractions toward the Social Security and Medicare programs.

The taxes have different rates, but both employers and employees must share the FICA payments as described below.

  • The Social Security tax rate is 12.4%, split between the employer and employee with a rate of 6.2% for each .
  • The Medicare tax rate is 1.45% for the employer and 1.45% for the employee, or 2.9% total.

There are many Medicare options available, and its normal for you to have questions. If you need help getting answers, feel free to give eHealth a call to speak with a licensed insurance agent about your coverage needs. Or, if you prefer, you can view Medicare plan options in your area right from your home just enter your zip code into the plan finder tool on this page to get started.

To learn about Medicare plans you may be eligible for, you can:

  • Contact the Medicare plan directly.
  • Contact a licensed insurance agency such as Medicare Consumer Guides parent company, eHealth.
  • Or enter your zip code where requested on this page to see quote.

Who Is The Primary Insurer Your Group Plan Or Medicare

When health insurance claims are filed, there is typically a primary insurer and a secondary insurer . Whether or not you should enroll in Part B depends on who is the primary insurer, Medicare or your group plan. How do you know? The number of people employed at your company is the deciding factor.

In companies with less than 20 employees: Medicare automatically becomes the primary insurer, with group insurance second. In this case, you should take Part A and Part B when you are first eligible. Why? If your employer is a secondary insurer, they pay after Medicare pays. By delaying Medicare benefits, you wont have a primary insurer, and what you pay out-of-pocket will be high.

In companies with more than 20 employees: Your employer becomes the primary insurer, with Medicare coverage second. In this case, you can delay enrolling in Part B as your group coverage will pay your medical claims.

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Medicare If Spouse Is Disabled

If one spouse is 65 and begins receiving Medicare and the other is not yet 65, there may be other ways to qualify. If you are diagnosed with ESRD or ALS or if you have been receiving SSDI for at least two years, you can qualify for Medicare regardless of your age.

The good news is that if you do qualify for Medicare based on a disability, you may also qualify for a Medicare Special Needs Plan at a low cost.

When Would I Enroll If I Delay Or Only Take Part A

What are the Eligibility Requirements for Medicare?

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, youll be able to enroll in Medicare Parts A & B. You can also enroll in a Part D prescription drug plan. And, after you enroll in Part B, youll be able to enroll in a Medicare supplement insurance plan or a Medicare Advantage plan.

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Does Medicare Cover Divorcees And Widows/widowers

If you are divorced and do not qualify for Medicare based on your own work history, you may still be eligible for Medicare based if all of the following apply:

  • You were married to that person for at least 10 years
  • That person qualifies for premium-free Part A
  • You are currently not married to anyone else

If your spouse has died, you may qualify for Medicare based on their work record if all off the following apply:

  • You were married for at least nine months before they died
  • They paid Medicare taxes for at least 10 years during their lifetime
  • You are currently not married to anyone else

How Do You Get Medicare At Age 65

When youre eligible for Medicare at 65, you might be automatically enrolled in traditional Medicare, also called Original Medicare, Part A and Part B. Medicare for your spouse will happen later, when she or he turns 65.

If youre aging into Medicare at age 65, you can still help with Medicare planning for your spouse. Together, you can learn about Medicare. For example, find out when to apply for Medicare.

Read Also: How To Enroll In Medicare Part D

Medicare Entitlement For Foreign Spouses

by Patricia Barry, AARP Bulletin, Updated September 2011

Q. I recently married a Canadian who has applied to become a permanent U.S. resident. Will he be able to get Medicare on my work record and pay the same rate as I pay, or will he have to buy into Medicare?

A. If your work record makes you eligible for full Medicare benefits, then your husbandwhatever his nationalitywill also be entitled to the same benefits at the same cost, provided he meets all the following conditions:

he is a legal permanent resident of the United States

he has been married to you for at least one year

he is age 65 or older.

But for people in other circumstances, the answer could be different.

If you do not qualify for Medicare on your own work record

To be eligible for Medicare at age 65 or older, you need at least 40 Social Security work credits. This generally means about 10 years of work. If you dont have sufficient credits, your foreign spouse could obtain Medicare only if he or she becomes an American citizen or has lived as a legal resident in the United States for at least five years. Once those conditions are met, your spouse could then buy into Medicare by paying a premium for Part A hospital insurancewhich people with enough work credits get for freeand paying the usual premium for Part B, which covers doctor visits and other outpatient services. In 2011, people buying into Medicare pay up to $450 a month for Part A coverage.

If you are in a same-sex marriage

What Happens When One Spouse Goes On Medicare And The Other Isnt Eligible

Medicare spouse coverage: Eligibility and criteria

Hans Scheil

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?

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Medicare After Death Of A Spouse

The death of a spouse can change many aspects of your life, including health policies. If you get benefits under your spouses retirement plan coverage may change after they pass away. If you lose Medicare coverage due to the death of a spouse, you become eligible for a Special Election Period but, that period doesnt last forever.

Social Security surplus helps fund the deficit to help those in need of survivor benefits or those on disability.

Its your responsibility to enroll in a new policy as soon as possible to ensure eligibility. If you recently lost a spouse and your Medicare policy, please call an agent at the number above to start discussing your options.

Why Does Medicare Only Cover Individuals

Medicare isnt just an insurance program its a set of health benefits that you earned by contributing income taxes over the years. Medicare only serves individuals who qualify. Subsequently, its not lawful to extend your coverage to other people.

Your spouse should apply for Medicare if he or she is eligible to do so. If your spouse is not eligible, he or she will need to seek his or her own health insurance. Beware of trying to get around a spouses ineligibility by staying on your private or employer-based insurance plan until he or she qualifies for Medicare. The rules are complicated, and failure to enroll in Medicare on time results in a large penalty.

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When Can Children Qualify For Medicare Coverage

Children may qualify for Medicare coverage if they have a disability as determined by the Social Security Administration .

Children with disabilities can qualify for Medicare coverage when they have been getting Social Security Disability Insurance for at least two years. The SSDI program pays benefits to adults who have a disability that began before they turned 22 years old. Social Security considers this SSDI benefit a childs benefit because it is paid on a parents Social Security earnings record.

For a disabled adult dependent to become entitled to SSDI, a parent must be receiving Social Security retirement or disability benefits or have died and had worked to earn enough quarters of coverage to qualify for Social Security benefits.

A disabled adult dependent can get Medicare immediately if they are diagnosed with ESRD or amyotrophic lateral sclerosis .

Children with ESRD may be eligible for Medicare if the following conditions are met:

  • You or your spouse have earned at least six credits within the last three years by working and paying Social Security taxes or are eligible for Social Security or Railroad Retirement Board benefits.
  • Your child has a kidney transplant or needs regular dialysis because their kidneys no longer work.

Contact Social Security to see if your disabled child meets eligibility requirements and to apply for Medicare.

Can You Get Medicare If You Have Never Worked

Married or divorce eligible for SAME social security spousal benefits #socialsecurity #divorce

As outlined above, you may still get Medicare even if you have never worked a day in your life. You may even potentially qualify for premium-free Part A, provided that your spouse has paid Medicare taxes for at least 40 quarters and meets all other Medicare eligibility requirements. Those 40 quarters do not need to be consecutive.

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Medicare & Health Insurance Options For Spouse Of A Medicare Recipient

If one spouse is ineligible for Medicare and needs to find a different health plan, dont panic there are plenty of options for health insurance for the spouse of a Medicare recipient. You might want to start by checking to see if that spouse is eligible for Medicaid based on your total household income. If the answer is no, youll want to start looking at individual health plans in your area, which you can do through healthcare.gov/.

If the Medicare spouse has insurance through an employer when they become eligible for Medicare, the non-Medicare eligible spouse can also try getting COBRA until they are also eligible for Medicare. COBRA allows an individual, couple, or family to continue health coverage after leaving a job. However, keep in mind that even if youre able to keep your health plan through COBRA, your costs may go up because your employer wont be sponsoring the plan for you anymore.

Can My Wife Get Medicare At 62

To get Medicare, you have to either be 65 or have a qualifying disability.

If your husband or wife is just a few years short of Medicare eligibility, they can select an ACA plan or enroll in a short-term health plan. Short-term medical insurance can be renewed for up to 36 months, so its a good option if youre within 36 months of becoming eligible for Medicare. Since these plans are designed for such short periods of time, they tend to be a bit cheaper than long-term plans, like the ones offered by your employer or the ACA.

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Medicare Premium Payments: How Much Does Medicare Cost For A Married Couple

How much does a married couple pay for Medicare? Medicare is 100% individual, so each spouse will have to pay their own premium. There are no joint plans with joint costs.

Your Medicare Part A monthly premium will depend on your and your spouses work history and will range between $0 and $458 per month in 2020. Your Medicare Part B premium will be $144.60 in 2020 . If you have Medicare Part D prescription drug coverage or either a Medicare Supplement or Medicare Advantage plan, youll pay a separate premium for those plans.

Joint Coverage For Medicare And Spouse

Medicare spouse coverage: Eligibility and criteria

Every now and then we speak to beneficiaries looking for a joint Medicare plan with their spouse. No matter who you are or what plan you choose, your Medicare will always be an individual plan. This means you will have your own Medicare claim numbers and your Part B premium will be paid separately.

With that said, there are some Medigap plans that will offer you significant savings on your monthly premium through a Spousal Discount even when you have separate Medicare claim numbers.

Our software at Boomer Benefits helps us to find the best discounts for you and your spouse when we are quoting Medigap policies.

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My Husband And I Are Retired He Just Turned 65 And Is Now Covered By Medicare But I Am 62 And I Dont Have Health Insurance As The Spouse Of A Medicare Beneficiary Can I Enroll In Medicare During The Medicare Open Enrollment Period

No. Although your husband now qualifies for Medicare, you will not qualify for Medicare until you turn age 65. If you do not have health insurance now, you can consider signing up for health insurance coverage through a Marketplace plan. If your household income is at least 100% of the federal poverty level , you may qualify for premium tax credits to reduce your cost of a Marketplace policy. If your household income is at or below 138% of poverty , you might be eligible for Medicaid if you live in a state that has expanded its Medicaid program.

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