The big question couples often ask about Medicare is: “Can I get Medicare benefits through my spouse?” Let’s go into what benefit you can share, what you can’t, and why that is.
What You Can Get
Medicare is complicated, and usually, coverage is individual (but more on that later). However, there is one benefit that spouses can share. Depending on eligibility, both of you can get Medicare Part A (Hospital Insurance) at age 65 without having to pay premiums.
You can be eligible yourself for premium-free Part A if you’re 65 and have worked at least 40 quarters in the US in which you paid Social Security taxes OR you are eligible for Railroad Retirement benefits. If you’re non-working and you don’t meet those criteria, that’s okay, because if your spouse meets the criteria, you can still be eligible to receive this Medicare benefit from them.
Here are a few scenarios where you would be eligible for premium-free Part A at age 65 through your spouse, who must be at least 62 years old:
- Married – If you’ve been married for at least one year, and your spouse is eligible for Social Security.
- Divorced – If you were married for at least 10 years, your former spouse is eligible for Social Security, and you are now single.
- Widowed – If you were married for at least nine months, your late spouse was eligible for Social Security, and you are now single.
To reiterate: the spouse that qualifies for Medicare must be 62 years old for the other to receive Medicare benefits because the non-working spouse’s qualification is based on the other’s work record.
What Happens if Your Working Spouse is Younger Than You?
You figure out you’re eligible to get premium-free Part A from your spouse – but what if you reach 65 first? You can still be eligible to receive Medicare benefits based on your spouse’s work record, even if they are not retired or receiving Medicare coverage themselves. In a case like this, they must be at least 62 years old. If they aren’t, you must wait until their 62nd birthday to enroll in premium-free Medicare Part A (which means you’ll pay the Part A premium until they become eligible).
What Happens if Your Working Spouse is Older Than You?
On the flip side, what if your spouse turns 65 before you? Unfortunately, you won’t be able to enroll in premium-free Part A until you turn 65. To bridge the gap, an option to consider is for you to buy individual health insurance until you turn 65.
What You Can’t Get
Essentially, sharing Medicare benefits begins and ends at Part A. A lot of the time, when people ask if they can share Medicare benefits with their spouse, the question really is, “Can a couple share the same Medicare coverage?” Unfortunately, the answer is no. No matter who you are or what plan you choose, your Medicare will always be an individual plan.
So you will have to enroll in Part B (Medical Insurance) and/or Part D (prescription drug insurance) during your initial enrollment period, Open Enrollment, or during a Special Enrollment Period. If you and your spouse are different ages, you will likely become eligible at different times.
Why Medicare Coverage Can’t Be Shared with a Spouse
So why can’t two people share the same Medicare coverage? The biggest reason is because everyone’s eligibility for Medicare is unique. Your qualifications for Medicare, as well as how much you will pay, depend on things like your birthday and work history.
Not to mention, the way Medicare works, each beneficiary’s coverage is tracked to the individual. Your number of office visits, how much you spend on premiums and deductibles, and the amount limit on services are all linked to you and you alone. This is different from how private health insurance works. The plans you’ve likely had in the past had a policyholder (the person who is insured directly) and dependents (like a spouse and children). For Medicare, it all comes down to the individual; one member per plan.
So even if you and your spouse are eligible for Medicare at the same time and may even enroll in similar Medicare plans, your eligibility and what you pay are directly tied to you, not you and your spouse together.
Let Us Help You Navigate Your Medicare Coverage
Does this all sound a bit overwhelming? You’re not alone! Navigating through the maze of Medicare can be a bit messy. That’s why the Jeffery Insurance team is here to help.
We will help you understand Medicare, answer any questions you have about coverage and benefits, and sign up for the plan that suits your needs and lifestyle. Even after you sign up for a plan, we are your Medicare advocates. That means we will be available every time you need us. We are based in Scottsdale but are happy to assist you no matter where you are in Arizona. Jeffery Insurance is Arizona’s health care resource!