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Can You Qualify For Medicare Through Your Spouse

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Medicare For Divorced Spouse

How to Enroll in Medicare on Your Spouse’s Work Record

The Social Security Administration requires you to meet specific criteria to qualify for Medicare benefits from a divorce. 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 wont 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.

If youre 62 and your spouse or ex-spouse is 65, you CANNOT use their Medicare benefits for eligibility. You must wait until the age of 65 to qualify unless youre eligible through disability.

If the following situations apply, you may qualify for Medicare after divorce:

  • Your ex-spouse is at least 62 years old and eligible for Social Security.
  • You must be currently unmarried.
  • Youre at least 65 years old.
  • You were married for 10+ years.

Part A benefits are free when you, a current or former spouse, have at least 40 calendar quarters of work or ten years of work history paying into Social Security.

Sometimes Group Insurance Changes When You Become Eligible For Medicare

Even if you know that your employer will be the primary insurer, take a look at your benefits. Sometimes they change when you become eligible for Medicare. Read over your group coverage benefits to see how they work once you or your spouse turn 65. Then decide if its better for you to enroll in Part B now or delay enrollment. Remember, Part B carries a monthly premium that you will be responsible for paying.

Rules For Medicare Eligibility Based On Spouses Work History

To qualify for Medicare Part A benefits at age 65 based on your spouses work history, you must meet one of the following requirements:

  • 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.
  • 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.

If you arent sure you meet a certain requirement, you can contact the Social Security Administration by calling 800-772-1213. You can also visit Medicare.gov and use their eligibility calculator.

Read Also: How Is Part B Medicare Premium Determined

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 Children

How to apply for social security spousal benefits ...

When you qualify for Social Security retirement benefits, your children may also qualify to receive benefits on your record. Your eligible child can be your biological child, adopted child, or stepchild. A dependent grandchild may also qualify.

To receive benefits, the child must:

Benefits stop when children reach age 18 unless they are disabled. However, if the child is still a full-time student at a secondary school at age 18, benefits will continue until the child graduates or until two months after the child becomes age 19, whichever is first.

Benefits paid for your child will not decrease your retirement benefit. In fact, the value of the benefits they may receive, added to your own, may help you decide if taking your benefits sooner may be more advantageous.

Recommended Reading: How Do I Get My New Medicare Card

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.

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.

Read Also: Is Medical Assistance The Same As Medicare

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.

Spouse Coverage And Social Security Work Credits

Will My Non-Working Spouse, Who Turns 65 Before Me, Get Medicare at Age 65?

For a person or their spouse to qualify for Medicare, they will need to have built up enough Social Security credits throughout their employment history.

Medicare credits link to Social Security work credits. In 2020, a worker receives one work credit per $1,410 they earn. They can earn up to four credits annually.

Self-employed individuals also receive up to four annual work credits per $1,410 of net earnings.

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.

The number of qualifying credits for people who have a disability varies according to the age at which they developed the disability.

A person who develops a disability between 3142 years of age will require 20 work credits for Social Security disability benefits.

A person who develops a disability at age 62, will require the full 40 credits to qualify for Social Security disability benefits.

Not every type of employment counts toward Social Security work credits. If the spouse works for a local or state government that does not participate in Social Security, they will not earn credits.

Those with more than 10 years of service working on the railroads do not pay into Social Security. Instead, the Railroad Retirement Board benefits cover Medicare plans.

The RBB deducts Medicare payments from their employees paychecks, and railroad workers receive the same benefits as anyone else.

Read Also: How To Fill Out Medicare Part B Application

Medicare Advantage Plans For A Non

If you and your spouse are eligible for Medicare Part A and Part B, then you are likely eligible for a Medicare Advantage plan.

Medicare Advantage plans offer the same benefits as Medicare Part A and Part B combined into one plan. 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.

Find Medicare Advantage plans in your area

Or call 1-800-557-6059TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

About the author

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.

His work has been featured in outlets such as Vox, MSN, and The Washington Post, and he is a frequent contributor to health care and finance blogs.

Christian is a graduate of Shippensburg University with a bachelors degree in journalism. He currently lives in Raleigh, NC.

Where you’ve seen coverage of Christian’s research and reports:

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.

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

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What About Penalties Will You Qualify For A Special Enrollment Period To Enroll In Medicare Later

With group coverage, you qualify for a Special Enrollment Period. That means you can enroll in Part B after the Medicare Initial Enrollment Period. You have 8 months after group coverage ends to enroll in Medicare without paying a penalty. If youre interested in Medicare Supplement Insurance, you will also have a guaranteed issue right to buy for six months after you enroll in Medicare Part B.

Underage Children Being Raised By Medicare Beneficiaries

When and How to Apply for Medicare? 3 Easy Ways

In 2010, the Affordable Care Act allowed young adults under the age of 26 to remain on their parents’ health plans. The problem? This provision does not extend to Medicare. That can put many families on the hook for paying out of pocket for other sources of health care.

  • Disabled parents may need to provide health coverage for their children. They will need to access alternate insurance coverage and this is most often through Medicaid. More than 10 million people for Medicaid based on a disability.
  • Challenges also arise for grand families and families where children are raised by their grandparents. More than 2.4 million grandparents are responsible for the needs of their grandchildren. Many of these grandparents will be older and on Medicare.

Health insurance marketplace or private insurance plans may be viable options to cover health care for these children.

Also Check: What Do You Need To Apply For Medicare Card

Medicare If You’re Married

You and your spouse’s Medicare coverage might not start at the same time. Medicare is an individual plan . However, you may be eligible for Medicare based on your spouses work history — even if you are not eligible on your own. You and your spouse’s Medicare coverage might not start at the same time. 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. Here’s what to know about costs:

Do Your Medicare Benefits Cover Your Spouse

In the United States, as soon as you turn 65 you are eligible for Medicare benefits if you are citizen or have been a legal resident for five years or more and have worked for at least 40 quarters paying federal taxes. You may also be eligible for Medicare coverage if you are younger than 65 but have a qualifying disability or end-stage renal disease.

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.

Your non-working spouse is eligible for premium-free Medicare Part A coverage at the age of 65 based on your work record and if you meet the necessary requirements for Medicare coverage mentioned above.

Medicare automatically enrolls you in Original Medicare. Most people get Part A premium-free at the age of 65 based on taxes paid while working. If you wish to sign up for Medicare Part B , and/or Part D , you must enroll separately during your initial enrollment period, Open Enrollment or during Special Enrollment Period to avoid paying late enrollment penalties. If you and your spouse are different ages, you will likely become eligible at different times.

What Happens if Your Spouse is Younger Than You?If your spouse is younger than you when you turn 65 and become Medicare eligible, he or she must wait until turning 65 to be automatically enrolled in premium-free Medicare Part A.

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Can You Get Medicare For A Non

Medicare isnt just for the retired workers. If you are a U.S. citizen or a legal resident for at least five years and meet eligibility requirements, then you can get Medicare.Eligibility requirements are:

  • You must be 65 years old or older
  • You are under 65 years old with a qualifying disability
  • You have End-Stage Renal Disease, which is permanent kidney failure that requires dialysis or a kidney transplant.

In short, your non-working spouse can get Medicare if he or she is eligible. However, we want to go into this in more detail.

As a working person, you pay Medicare taxes through payroll deductions. If you work and pay taxes for at least 10 years, you qualify for premium-free Medicare Part A coverage, which is hospital insurance, when you turn 65 years old. When and if you qualify, your non-working spouse can qualify based on your work record when he/she turns 65 years old, as well. You both will qualify for Medicare Part B, which is medical insurance. For Part B, you both must pay a premium monthly.

When you turn 65, you should enroll in Medicare, whether or not you are still working. If your spouse turns 65 after you, he/she will need other health insurance in the meantime, whether its through your employer or through the Health Insurance Marketplace. If your non-working spouse turns 65 before you, he/she can qualify for Medicare on your work record even if youre not on Medicare or Social Security yourself, but you must be at least 62 years old.

Medicare At Age 65 If Your Younger Spouse Is Still Working

Can I delay Medicare at 65 if I am covered by my Spouse’s Employer Plan?

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.

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