Thursday, March 12, 2015

I've got Medicare. But what about my spouse?

Are you concerned whether your spouse will be eligible for Medicare, even if he or she does not work or have an employment history? The short answer is yes, your spouse is eligible as long as he or she is a U.S. Citizen or legal resident for at least five years and meets one or more of the following requirements:

    1)  Age 65 or older
    2)  Under age 65 but has a qualifying disability
    3)  Has End-Stage Renal Disease

If you are an employed person, you need to work and pay taxes for at least 10 years to qualify for premium-free Medicare Part A (hospital) coverage when you turn age 65. Your spouse may qualify based on your work record once he or she turns 65. You both would also qualify for Medicare Part B (medical) coverage for which you would pay a monthly premium.

It gets more complicated when we look at what happens when one of you turns 65 before the other.

If you are turning 65 first, your first step should be to enroll in Medicare for yourself. If your spouse is younger than you, he or she will need other health insurance coverage until they turn 65 and become eligible for Medicare. This may be coverage through your employer if you are working, COBRA coverage or your spouse may need to purchase individual coverage.

If your non-working spouse is older than you, he or she may qualify for Medicare at age 65 based on your work record, but only if you are at least 62 years old. (The key is that you qualify for Social Security at age 62. You don’t have to file for Social Security for your spouse to get benefits. You only have to be old enough to do so.)

If you have the option of covering your spouse through your employer’s health insurance, he or she may prefer to enroll only in premium-free Medicare Part A until you retire or your employer coverage ends. As long as the employer provided insurance is creditable, meaning as good as what Medicare provides, there will be no penalties incurred.

If your spouse is more than 3 years older than you when they turn 65, then he or she may purchase Medicare Part A until you turn 62 and the premium-free Medicare Part A becomes available.


While these are the general guidelines, it’s always best to discuss your specific situation with an insurance professional.  At Mutsko Insurance Services, we will review all your options and help you decide what’s best for you and your spouse. Call me at 440-255-5700 or email Lmutsko@mutskoinsurance.com for more information. 

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