If you are turning 65 soon you may be wondering whether your spouse is also covered by your Medicare plan.
Unfortunately, unlike employer-provided health insurance, Medicare is coverage for individuals only and does not extend to cover any other family members, including your spouse.
What should I do if my spouse needs health insurance?
If you are still working when you turn 65, you may continue to have your spouse covered as a dependent under your employer-provided insurance coverage.
However, if you are thinking of retiring and your spouse is under the age of 65 and not eligible for Medicare (because of a disability or illness), they will have to obtain insurance coverage either through other channels. This could include:
- Through their own employer if they are still working;
- Purchasing an Affordable Care Act (ACA) plan (also known as Obamacare); or
- Through COBRA which your employer provides after your retirement for a maximum period of 18 months.
How does my spouse get Medicare?
If your spouse is over the age of 65, he/she may be eligible for their own Medicare coverage. In order to be eligible your spouse must be U.S. citizen or a permanent resident who has lived in the U.S. continuously for 5 years.
Most Americans turning 65 will qualify for premium-free Part A. In order to be eligible, you must have paid Medicare taxes for at least 10 years (40 quarters). If your spouse didn’t individually pay Medicare taxes for at least 10 years, they may not qualify for premium-free Part A based on their own individual contribution. However, if you and your spouse have been married for at least 10 years your spouse may be eligible to receive premium-free coverage through your contributions. If you are divorced and were not previously working, you may also qualify if you were married for at least 10 years prior to divorce.
Why does Medicare not cover my spouse?
Medicare does not cover your spouse as the federal government budgets and pays for Medicare expenses on an individual basis. In addition, coverage such as premium-free Part A, is provided based on individual contribution income taxes over the years.
For example, if you are receiving Medicare coverage from a Medicare Advantage (Part C) plan, the government pays the private health insurance company a fixed amount per month for care delivered to you. This payment amount only covers care delivered to you and does not include payments for your spouse (or other family members).
Final words
Medicare does not cover your spouse. If you (or your spouse) are turning 65, you should assess your options. If you intend on continuing to work, your spouse may continue to be covered under your employer-provided coverage (for more information on Medicare When Working Past 65, see this article). If you do not have employer coverage, your spouse may need to obtain coverage through their employer or purchase individual insurance such as an ACA plan.
If you are ever unsure what to do, make sure to reach out to a licensed agent who can help. At CoverRight, we’re here to help you find the right coverage that you deserve. Reach out today and start finding the best Medicare plan for you.
