Summary: Though you cannot be covered by your spouse’s Medicare, your martial status can affect your Medicare coverage in other ways. Individuals who do not qualify for premium-free Medicare Part A may be eligible through their spouse’s work history. Additionally, being married can impact your Medicare premiums as well as your eligibility for Medicare Savings Programs and Extra Help. In this article, we’ll explore important details regarding getting Medicare when you’re married, divorced, or widowed. Estimated Read Time: 6 min
Can You Get Medicare Through Your Spouse?
Unlike traditional health insurance plans, you cannot get Medicare coverage through your spouse. Each person must individually qualify for Medicare to enroll in coverage. This means that even if your spouse turns 65 and enrolls in Medicare, you will not be eligible for coverage until you turn 65 as well (unless you qualify under age 65 due to a disability).
Medicare plans, including Medicare Advantage plans, Medicare Supplement plans, and Medicare Part D Prescription Drug plans can only cover one person. It is important that you and your spouse each look at your individual healthcare needs when deciding what coverage you should enroll in. A plan that fulfills your healthcare needs may not fulfill the needs of your spouse and vice versa.
Though you cannot share Medicare coverage with your spouse, your marital status can affect your Medicare coverage in other ways. Being married can help you qualify for premium-free Medicare Part A if you haven’t worked and paid Medicare taxes for enough years to qualify on your own. Additionally, your martial status can also have an impact on whether you qualify for Extra Help for Medicare Part D.
Qualifying for Premium-Free Part A Through Your Spouse
To qualify for a $0 premium for your Medicare Part A, you must have worked and paid Medicare taxes for at least 40 quarters, or 10 years. If you haven’t met this requirement, you will need to pay a monthly premium for your Medicare Part A coverage.
However, if you are married, you may qualify for premium-free Medicare Part A through your spouse’s work history.
You and Your Spouse are Currently Married
If you are your spouse are currently married, you must meet the following requirements to qualify for premium-free Medicare Part A through your current spouse:
- Your spouse must be at least 62 years old and eligible for Social Security benefits
- Your spouse worked and paid Medicare taxes for 40 quarters (or 10 years)
- You and your spouse have been married for at least one year
You and Your Former Spouse are Divorced
Even if you and your (former) spouse are divorced, you can still qualify for a $0 premium Medicare Part A if you meet the following criteria:
- Your former spouse worked and paid Medicare taxes for 40 quarters (or 10 years)
- Your former spouse must be at least 62 years old and eligible for Social Security benefits
- You and your former spouse must have been married for at least 10 years
- You must currently be unmarried
You are Widowed
If you are a widow or widower, you may still be able to use your spouse’s work history to qualify for a $0 premium for your Medicare Part A coverage. The following requirements must be met:
- Your spouse worked and paid Medicare taxes for 40 quarters (10 years)
- You and your spouse were married for at least nine months prior to your spouse’s death
- You must currently be unmarried
Can My Non-Working Spouse Get Medicare Coverage?
A non-working spouse can get Medicare coverage when they individually become eligible. Regardless of when you become eligible for Medicare, your spouse cannot get Medicare coverage until they turn 65 (or become eligible under 65 due to a disability).
If your non-working spouse is under 65 and was covered under your employer health plan, it is important to know that they will not be able to be covered under your Medicare coverage if you retire and lose your employer health insurance. In this case, your spouse will need to get an individual health plan or apply for Medicaid until they are eligible for Medicare.
Once your spouse is eligible for Medicare, they can use your work history to qualify for a $0 premium for their Part A coverage. If your spouse becomes eligible for Medicare before you do, you must be at least 62 years old for your spouse to use your work history to qualify for the $0 premium Part A.
If you and your spouse are struggling with your Medicare costs, Medicare Savings Programs can help reduce your out-of-pocket healthcare expenses. These programs are designed to help low-income individuals with their premiums, deductibles, and copayments. You and your spouse’s combined income and resources will be considered when you apply.
Does Being Married Affect Your Medicare Costs
Since each person must get Medicare coverage individually, being married will have little effect on your Medicare costs. You and your spouse must each pay your own premiums, deductibles, copayments, and coinsurance for your Medicare coverage.
Though being married doesn’t impact your costs directly, it can impact your costs indirectly. If you are married and file your taxes together, your combined income is considered when determining if your Medicare Part B and Medicare Part D premiums will be higher due to IRMAA. Remember, IRMAA is based on your modified adjusted gross income from two years ago – so if you’re newly married, your joint income won’t be considered for IRMAA for two years.
Additionally, your spouse’s income and resources will be considered when determining whether you qualify for Extra Help. In some cases, you may qualify for Extra Help as an individual, but no longer qualify after getting married due to your spouse’s income and resources. No longer qualifying for the Extra Help program may result in your costs for prescription drugs being higher.
Frequently Asked Questions Regarding Marriage and Medicare Benefits
Though we covered a lot of information above regarding marriage and Medicare benefits above, there are some unique situations that you may experience.
What’s the best way to apply for Medicare if I plan on using my spouse’s work history to qualify for premium-free Part A?
If you are planning on enrolling in Medicare and using your spouse’s work history to get premium-free Part A, you should sign up for Medicare over the phone or in person at your local Social Security office. Whether you sign up over the phone or in person, your spouse should be with you.
What happens if I qualify for a $0 premium for Part A through my ex-spouse’s work history but decide to remarry?
It’s not uncommon to remarry after a divorce. If you are currently paying a $0 premium for your Medicare Part A due to your ex-spouse’s work history, and decide to remarry, you will no longer be eligible to use your ex-spouse’s work history to qualify for a $0 premium for Part A.
You will need to qualify through your new (current) spouse’s work history. If your current spouse is under the age of 62 or is over 65 and has not paid Medicare taxes for at least 10 years, you may end up having to pay for your Part A coverage each month.
What if neither me nor my spouse have paid enough taxes to qualify for a $0 premium for Part A?
If neither you nor your spouse are eligible for Medicare Part A with a $0 premium, then you will both need to pay a monthly premium for Part A coverage (if you sign up). Remember, enrolling in Medicare is not a requirement, however, if you wait to enroll, you could face late enrollment penalties down the road.
I am currently paying for Medicare Part A. My spouse, who has enough work credits to qualify for premium-free Medicare Part A just turned 62. Do I have to keep paying for Medicare Part A?
This situation isn’t uncommon for individuals who have spouses that are a few years younger. Let’s say you enrolled in Medicare Part A when you turned 65 but did not have the work history to qualify for a $0 premium. Your spouse does, however they are only 61 years old, so you cannot use their work history to get a $0 premium.
Fast-forward a year, and your spouse turns 62. Now you are eligible for a $0 Medicare Part A premium through your spouse’s work history. You can have your costs re-evaluated by contacting Social Security and asking for an appeal.
Sources
Medicare & You 2024 The Official U.S. Government Medicare Handbook, Medicare.gov. Accessed February 2024
https://www.medicare.gov/publications/10050-Medicare-and-You.pdf
