Wednesday, July 10, 2024

Will I Lose Medicare If I Get Married

Don't Miss

Do Domestic Partners Qualify For The Same Special Enrollment Periods As Married Couples

Medicare Part B Changes for 2023

No. While many group health plans recognize domestic partnerships, Medicare does not. This often comes into play when one partner loses their job-based coverage. If their partner is older than 65 and covered under the group plan, theyll be subject to the Part B late enrollment penalty. For married couples, this is considered a QLE.

How Do I Get Medicare Eligibility

According to the U.S. Department of Health and Human Services, there are generally three ways to have Medicare eligibility.

  • Age: if you are 65 or older, you generally are eligible for Medicare. According to the Kaiser Family Foundation, the distinct majority of Medicare beneficiaries qualify by age.
  • Disability: According to the Social Security Administration , everyone eligible for Social Security Disability Insurance benefits is also eligible for Medicare after a 24-month qualifying period. Generally a disability that gives you Medicare eligibility must be âsevere.â According to SSA, disability is defined as âthe inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which
    • can be expected to result in death or
    • which has lasted or can be expected to last for a continuous period of not less than 12 months.â
  • Mental disorders such as schizophrenia and bipolar disorder, endocrine disorders such as diabetes mellitus, and cancer may qualify you for disability under Social Security and therefore Medicare eligibility.
  • Certain health conditions such as end-stage renal disease or Lou Gehrigâs disease may also give you Medicare eligibility without the 24-month waiting period. Starting in 2021, if you have ESRD, youâre generally also eligible for a Medicare Advantage plan.

    Does Medicare Offer Spouse Coverage

    Medicare does not offer health coverage for spouses. You would have to be eligible on your own to qualify for Medicare your spouses eligibility does not affect yours.

    According to the rules set in place by the Centers for Medicare & Medicaid Services, marriage can affect your Medicare in the following ways:

  • Eligibility for Medicare cost savings can change due to your spouses income
  • Your Part D premiums can be higher due to your spouses income
  • Premium-free Part A eligibility can be determined based on your spouses work history if they worked more than you.
  • So, can you get Medicare through your spouse? Not technically, no but your marital status is not irrelevant.

    Also Check: Does Medicare Cover Transportation To Dialysis

    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.

    Will Marriage Affect Your Ssdi Benefits

    Medicare card

    If you are disabled and are applying for SSDI, your eligibility for benefits would be based on how long you have worked and whether you have acquired enough work credits. In addition, you must meet the Social Security Administrations definition of disability to qualify for benefits.

    If you decide to get married, this will not affect your eligibility for SSDI benefits. In addition, your spouses income would not be used to reduce the amount of your monthly payment.

    Recommended Reading: How To Avoid Medicare Part D Penalty

    Joint Meeting With A Licensed Agent

    Even if you and your spouse have different Medicare plans, you can still share an agent! Sharing an agent will make your enrollment process easier and help you build a relationship with someone who knows everything about Medicare plan options and can help you find savings.

    Do you have a licensed agent? Have more questions about spouse Medicare? Give us a call today to set up a free meeting. Our agents are licensed to sell several different insurance plans, so they can offer you an unbiased opinion and help you find the plan that truly works best for your needs. Call us at 1-844-431-1832.

    Does Marriage Affect Eligibility For Medicaid And Medicare Benefits

    If you receive concurrent benefits, what will also likely change if you get married is your dual eligibility status for Medicare and Medicaid. Medicare and Medicaid have a complicated system called “Medicaid crossover,” which helps people who are eligible for Medicare due to SSDI but can’t afford its premiums and copays. People with dual eligibility usually qualify for help paying Medicare premiums and deductibles through “Medicare Savings Programs,” which are administered by state Medicaid agencies. This is sometimes called getting “Medi-Medi” . There are three Medicare Savings Programs that can help dual eligibles:

    • Qualified Medicare Beneficiary program
    • Specified Low-Income Medicare Beneficiary program, and
    • Qualifying Individual program.

    If your income increases, you may no longer qualify as a Qualified Medicare Beneficiary , which means you might be subject to more out-of-pocket costs, but you could still qualify under the Specified Low-Income Medicare Beneficiary or Qualifying Individual program, which would still cover your Medicare premiums. You could also continue to receive “Extra Help” paying for Medicare Part D. Contact Social Security or your state’s department of health care services about how marriage would affect dual eligibility for you and your new spouse.

    Also Check: When Is Open Enrollment For Medicare

    Will I Lose My 401k Ira Stocks Or Savings

    The short answer is maybe, it depends on your state and the combined value of these assets. However, by working with a Medicaid planner, it is likely the non-institutionalized spouse will be able to keep most of these assets.

    Unlike income, where a Medicaid recipients income is considered separate from his or her spouse, a married couples assets are considered jointly owned and are used to determine Medicaid eligibility. This holds true even if the assets, such as a savings account, are only in one spouses name. Of course, certain assets, such as your home, household goods, vehicle, and personal belongings are exempt. .

    Countable assets include:

    • Stocks and bonds
    • Property that is not your primary residence

    Independent Retirement Accounts and 401Ks are a little bit trickier. For example, there are approximately 20 states that allow a community spouses 401K or IRA to be exempt, given the asset is fully owned by him or her.

    In most states, as of 2019, a non-institutional spouse is permitted to keep up to $126,420 in assets, in addition to their home and vehicle.

    You May Like: Does Medicare Or Medicaid Pay For Glasses

    Do I Need Part D If I Have Drug Coverage Through My Spouse

    5 Things Medicare Doesn’t Cover (and how to get them covered)

    Not necessarily. The rules are different for Medicare Part D prescription drug coverage. As long as you continue to receive creditable prescription drug coverage under the employer plan whether your spouse is still working or retired you do not need to sign up for a Part D plan.

    If you lose this coverage at some point, you will then be eligible for a special enrollment period of two months to purchase a Part D plan without incurring a late-enrollment penalty.

    Keep in mind

    Youll have different decisions to make if the spouse with employer health coverage turns 65 first. If the older spouse enrolls in Medicare instead of keeping the employers insurance, the younger spouse may lose private health insurance coverage. If that happens, a younger spouse may need to find other sources of coverage before turning 65 and becoming eligible for Medicare.

    One option is to continue the employers coverage through COBRA, which can last up to 36 months if you lose employer coverage because your spouse becomes entitled to Medicare. Or you can buy a private plan through the Affordable Care Act federal insurance marketplace or through a state that has its own exchange.

    Don’t Miss: Does Medicare Plan F Cover International Travel

    Divorced Spouses Survivors Benefit

    An ex-spouse who is receiving benefits based on her deceased ex-husband or wifes record will lose these benefits if she or he gets married before a certain age. If the surviving divorced spouse remarries after age 60 , the SSA will ignore the marriage.

    For more information on SSDI benefits for ex-spouses, see our article on getting disability as the divorced spouse of a disabled person.

    Social Security Disability Insurance

    SSDI is the benefit paid to disabled workers who have paid taxes into the Social Security for multiple years. To receive SSDI, you have to fit the Social Security Administration’s definition of disability, but you can be unmarried or married. Getting married won’t ever effect SSDI benefits that you collect based on your own disability and your own earnings record.

    However, certain dependents of a disabled worker can receive SSDI auxiliary or survivor benefits based on the disabled worker’s earning record. Some of these dependents’ benefits are given only to family members who are unmarried.

    Read Also: Can I Change From Medicare Supplement To Medicare Advantage

    How Much Ssi Will I Lose If I Get Married

    The treatment of marriage is a frequent consideration in the discussion of government benefit policies. In the Supplemental Security Income program, for example, two recipients married to each other receive a benefit that is one-quarter less than if they simply lived together but not as husband and wife.

    What Is The Medicaid Marriage Penalty

    In Charts, How Medicare for All Would Make Most Families Poorer

    What is the Medicaid marriage penalty?

    The Medicaid marriage penalty is when a Medicaid recipient loses his / her benefits as a result of getting married. Remember, Medicaid is a needs based program, which means a beneficiary must have limited financial means. Unfortunately, a marriage can push a beneficiary over the Medicaid set limits and result in Medicaid disqualification of the newly married spouse.

    As further explanation, in order for a senior to be eligible for Medicaid, they must have income and assets under a specified level. . These limits vary based on marital status, as well as state. However, as a general rule of thumb, for regular Medicaid, often called aged blind and disabled Medicaid, a single individuals monthly income is limited to either 100% of the Federal Poverty Level or 100% of the Federal Benefit Rate . Assets are normally limited to $2,000. Now, consider the income and asset limits of a married couple , which is not significantly higher than for a single person. Generally speaking, they are limited to either 100% of the Federal Poverty Level or 100% of the Federal Benefit Rate , but as a household of two. The asset limit, in most cases, is $3,000. Therefore, if the non-Medicaid spouse has even a modest income or minimal assets, the marriage penalty could definitely come into play and result in the disqualification of benefits.

    Recommended Reading: How To Check Medicare Payments

    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.

    What Is Not Covered Through Your Spouses Medicare

    Your spouses Medicare plan wont provide health coverage for you. If youre looking for Medicare for spouses, youll have to wait until the other spouse is eligible. Then, you can talk to an agent about finding separate plans that work for both of you and both fit into your household monthly budget.

    Read Also: What Age Does Medicare Eligibility Start

    Qualifying For Medicare Savings By Marriage

    There are several ways that marriage can save you money in Medicare. Each part of Medicare has its own rules. When you file taxes jointly, you may be put into a different income bracket that will change how much you are required to pay for your Part B or Part D premiums. Depending on your joint income, you may also be eligible for different Medicare savings programs. The income thresholds for these programs may be less for than for single people.

    The biggest benefit comes with Medicare Part A coverage. You can receive this hospital insurance for free, meaning that you will not pay a monthly premium, if you have worked 10 years in Medicare-eligible employment. Essentially, the government wants to know that you paid your fair share of Medicare taxes into the system. It may be the case that you have not worked an adequate number of quarters to qualify you. However, you can be eligible for free Part A premiums on your spouse’s record.

    For this to happen, your spouse needs to be eligible for Social Security and have contributed 40 quarters in Medicare-taxed employment. You must also be married for at least one year before applying for free Part A benefits.

    Is There Any Way To Change The Law To Give Disabled People Marriage Equality

    Why I Would Never Choose Medicare Advantage

    On January 13, 2022, Rep. Jimmy Panetta introduced H.R. 6405, which, if passed, would change current law to allow DAC recipients to freely marry without losing their benefits. A resolution in the California legislature, SJR 8, supports the elimination of DAC marriage penalties.

    Other legislation, including S. 2065, would help eliminate the penalties that prevent SSI recipients from freely marrying.

    Also Check: When Does Permission To Contact Expire Medicare

    Will Carrie Lose Her Cdb Or Medicare

    It depends on whether Daniel himself is receiving Social Security benefits . Since neither Medicare nor CDB are âmeans-testedâ programs, the Social Security Administration will not look at Carrieâs assets or Danielâs income and assets to determine whether she is eligible. She has been eligible for CDB and Medicare simply because of her disability that began before age 22 and the retirement of her father, who has a Social Security work record. Her marriage to another social security recipient would not cause her to lose her own CDB eligibility. However, if Daniel is not a social security beneficiary, Carrie would lose her own CDB eligibility that derives from her fatherâs status as a retired Social Security wage earner. If Carrie instead had been receiving a Social Security Disability Insurance benefit, based upon her own work record, as a result of later onset of her disability, she would not lose her SSDI entitlement due to marriage.

    What Couples Need To Know About Medicaid

    A guide to the qualification rules when only one spouse needs benefits

    The rules for Medicaid benefits can be tricky for married couples, especially when only one spouse needs the benefits. Medicaid assumes that both spouses of a married couple are financially responsible for one another. As a result, when Medicaid determines a spouses eligibility for benefits, the assets of the husband or wife who isnt applying known as the community spouse are expected to contribute to the care of the other. The Law Protecting Spouses

    Thats why the full financial history of both spouses is assessed when ascertaining Medicaid eligibility. However, The Spousal Impoverishment Act protects the community spouse from becoming severely impoverished. The guidelines specify the community spouses ability to keep some income and assets, while still allowing the applicant the option to obtain Medicaid benefits.

    As a general rule, the husband or wife who isnt applying for Medicaid benefits may keep up to half of both spouses joint liquid assets. But there is a limit to the amount of countable assets that the non-applicant spouse can keep. Known as the Maximum Community Spouse Resource Allowance , the limit is currently $117,240. Next year, the limit will rise to $119,220.

    Please note: Medicaid qualification guidelines vary from state to state and may change from year to year. An Example of One Married Couple

    Read Also: How To Get Help With Medicaid

    Recommended Reading: Does Medicare Cover Urgent Care Centers

    When You Can Enroll The Basics

    Before we dive into the different situations that can happen when you and your spouse enroll in Medicare, it might help to revisit some of the basics especially when it comes to when youre eligible to enroll.

    To be eligible for Medicare you must be a United States citizen or lawfully present in the United States. You must also:

    • Be age 65 or over, OR
    • Be under age 65 with certain disabilities, OR
    • Have end-stage renal disease

    So, the key to eligibility for many is age namely, when those 65 candles show up on your birthday cake. The work history of you or your wife, husband or domestic partner doesnt matter when it comes to being eligible to enroll.

    Medicare simplified: your step-by-step guide

    If youre about to join Medicare, this guide answers some of the most frequently asked questions.

    Can I Keep My Coverage If I Dont Report My Marriage To Medicaid

    How to Appeal a Higher Medicare Part B Premium

    If you dont report your marriage to Medicaid, you could be subject to penalties. Medicaid is a needs-based program, meaning your eligibility is based on your income and assets. You could be charged with fraud if you dont report a change in your marital status.

    In some cases, you may avoid penalties if you can prove that you did not intentionally withhold information about your marriage. However, its always best to err on the side of caution and report any changes in your circumstances to Medicaid as soon as possible.

    A Medicaid fraud conviction can result in a fine of $500 or imprisonment for one year, followed by probation. We do not recommend hiding your marriage from the federal government, as this can result in fraud charges from Social Security, the IRS, and Medicaid.

    Also Check: How To Get Medicare To Pay For Hearing Aids

    More articles

    Popular Articles