Medicare coverage for spouses
- Jim Miller: Savvy Senior
- January 16, 2024
- 469
Dear Savvy Senior,
Are spouses who have not worked outside the home eligible for Medicare benefits? I have worked most of my adult life, but my wife has been a mother and homemaker since we got married and hasn’t held an income-producing job since she was in college. Will she be eligible for Medicare?
Searching Spouse
Dear Searching,
There are many couples in your situation when it comes to applying for Medicare. The answer generally is yes, your spouse can qualify for Medicare on your work record. Here’s how it works.
Medicare requirements
Medicare, the government health insurance program for older adults, covers around 60 million Americans age 65 and older, as well as those younger who have a qualifying disability or have end-stage renal disease.
To be eligible, you must have worked and paid Medicare taxes for at least 10 years to qualify for premium-free Medicare Part A hospital coverage when you turn 65. If you qualify, then your nonworking spouse will qualify too, based on your work record, when she turns 65.
Divorced spouses also are eligible if they were married at least 10 years and are single, as are surviving spouses who are single and who were married for at least nine months before their spouse died.
In addition to Part A, both you and your spouse would qualify for Medicare Part B, which covers doctor visits and other outpatient services but requires a monthly premium. The premium for Part B beneficiaries in 2024 is $174.70 per month per person. Couples filing jointly with incomes over $206,000 per year pay even more.
There also are a number of other caveats you should know about, depending on your wife’s age.
Older spouses
If your wife is older than you, she can qualify for Medicare on your work record at age 65, even if you’re not getting Medicare yourself, but you must be at least 62 years old. You also must have been married for at least one year for your wife to apply for Medicare on your work record.
If you are still working and your wife is covered by your employer’s health insurance, she may want to enroll only in the premium-free Medicare Part A until you retire or your employer coverage ends. Part B — along with its premium — can be added later without penalty as long as your employer’s group health plan is your primary coverage. Check with your employer's human resources department to find out about this. If your wife is funding a health savings account, she may not want to take Part A because she can’t make contributions after she enrolls.
Younger spouses
If your wife is younger than you, she will need health insurance until she turns 65 and becomes eligible for Medicare. This may be through the Health Insurance Marketplace (see www.healthcare.gov) or through COBRA (see www.dol.gov/general/topic/health-plans/cobra) if you’re still working.
Other Medicare choices
In addition to Medicare Part A and B, when you and your wife become Medicare eligible, each of you will need to enroll in a Part D prescription drug plan if you don’t have credible drug coverage from your employer or union. And you may want to purchase a Medicare supplemental (Medigap) policy to help pay for things that aren’t covered by Medicare like co-payments, coinsurance and deductibles. Or you may want to consider an all-in-one Medicare Advantage plan.
For more information on Medicare choices and enrollment rules, visit www.Medicare.gov or call 800-633-4227. You also can get help through your State Health Insurance Assistance Program (see www.shiphelp.org), which provides free Medicare counseling.
Send your senior questions to Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.SavvySenior.org.