Medicare coverage is open to any US citizen provided they meet the basic requirements.
Recipients need to reside in the United States for a minimum of five years.
They also have to meet at least one of the following qualifications:
* Be 65 years old or older
* Be diagnosed with a listed qualifying disability
* Be in End-Stage (stage 4) Renal Disease (e.g. suffering from kidney failure and requiring kidney transplant or dialysis)
Many US citizens have the same question: Can my spouse receive Medicare if they don’t work?
Yes! Spouses need to meet the eligibility requirements described above. “Yes” is the short answer, but it’s not the whole answer.
Medicare is paid for by payroll deduction taxes levied on all employees. In order to properly qualify for Medicare Part A (or hospital insurance) without premiums, you need to have paid Medicare taxes for at least 10 years before turning 65. If you then qualify in this manner, your work record may allow your spouse to qualify as well. In this scenario, you would both also qualify for Part B Medicare coverage. Monthly premium payments are required for everyone receiving Part B coverage.
Many couples are different ages, reaching the key age of 65 at various times.
When one spouse reaches the age of eligibility first, how does it change the situation?
If you have a younger Non-Working Spouse
Everyone at age 65 should enroll for Medicare regardless of their future working plans. Further decisions, like enrolling in Part A alone or in both Part A and Part B, will have to be made based on your unique circumstances.
When your spouse reaches Medicare eligibility at age 65, they need another form of health insurance. If you continue to work, you may meet this need with your employer’s insurance plan. Some employers offer COBRA or similar alternatives for retired employees’ younger spouses. Talk to your health plan administrator about your spouse’s situation to learn more. Spouses always have the option of buying individual insurance through your state’s Health Insurance Marketplace until reaching the age of 65.
If The Non-Working Spouse Is Older
A non-working spouse may, in fact, qualify for Medicare based on your own work record even if you haven’t claimed Medicare or Social Security yourself. You need to be 62 (the minimum qualification Social Security age) for your spouse to receive Medicare in this situation. Whether or not you have filed for benefits is irrelevant. Only the right age matters.
Should your spouse maintain insurance coverage through your employer before you retire, they may opt to enroll in Medicare Part A only. Part B and the premiums associated with it can still later be added. There will not be a penalty if the employer coverage used before is “creditable.” This means that the employer insurance provides benefits as good or better than Medicare’s.
A spouse, older than you by 3 years, can buy Part A coverage for the time until you’re 62. At that point, the premium-free benefits take effect.
Medicare Part D
You and your spouse need to be careful about the timing of your enrollment into Medicare Part D coverage (prescription drugs). Each of you needs to enroll into a Part D plan while you are in your Initial Enrollment Period. You may also use creditable coverage for drugs from another source, as above. Otherwise, you may have to pay a penalty on your premium to enroll in Part D later on. If you transition from creditable coverage to the Part D plan, note that you have only 63 days after the end of your previous coverage to enroll without penalties.
Why Go It Alone
If you have any questions or would like more information, please call us at 1 800 717 2183 or visit our contact page and send us a message.