Does Medicare Provide Coverage For My Spouse?

Medicare is an individual health insurance plan, meaning that it is not meant for spousal coverage. However, one’s spouse can influence eligibility and coverage options.

What Medicare Cannot Do

Unfortunately, your Medicare coverage will not provide the coverage you were likely hoping for to your spouse. Any benefits one person receives through their Medicare plan will not be extended to the other. For your spouse to receive Medicare coverage, they must be enrolled in their own Medicare plan.

Working and Medicare Spouse Eligibility

Though you cannot share a Medicare plan with your spouse, there are many unique ways you and your spouse can influence each other’s Medicare coverage. For instance, if you want to enroll in a program like Extra Help or Medicaid, your income limit is based on the number of people in your household, even if they are not receiving the same coverage.

You or your spouse’s work history also plays a huge role in your Medicare options and choices. While you may not be able to cover your spouse with your Medicare plan, you can help them enroll in better coverage or vice versa.

Eligibility for premium-free Medicare Part A is determined by work history. If you have a limited work history, you can pay up to $471 a month for coverage. However, if you have ten years or more of work history while paying Social Security taxes, you will not have to pay this premium.

What does this mean for your spouse? If they do not qualify for premium-free Part A, your work history will make them automatically eligible for it, and vice versa.

If you or your spouse is younger and/or still working, it may also influence your choice on when to enroll in Medicare. Working individuals should receive some health insurance from their employer. If they are still working when they are eligible for Medicare at age 65, they get to decide if they want to keep just their employer coverage or have both it and Medicare at the same time.

If you are not working and choose to delay your Medicare enrollment, you will be charged with late enrollment fees when you do enroll. However, this is not the case if your spouse is still working. If you are covered by your spouse’s health plan but are not working yourself and are eligible for Medicare, you will not be penalized if you choose to delay your enrollment until they retire.

Medicare COBRA

This concept applies to what is called the “COBRA” law. COBRA may let you keep your employer group health plan, called “continuation coverage.” You can still receive your employer benefits for a limited time after your employment ends, or you lose coverage as a dependent of the covered employee. This is typically an 18-36 month window to delay Medicare enrollment for both you and your spouse.

Figure Out Your Coverage with Proinsurance Hawaii

You and your spouse may have a lot of questions about your coverage. You may not even be sure where to begin. Proinsurance Hawaii will help with both of your Medicare journeys. To get started, give us a call today at 808-735-0106.