Medicare spousal coverage

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My spouse has been a stay-at-home parent and homemaker since we got married and has not held an income-producing job for years. Will they be eligible for Medicare?

Many couples find themselves in a similar situation when applying for Medicare. In most cases, your spouse can qualify for Medicare on your work record. Here is how it works.

Medicare Requirements Medicare is a government health insurance program for older adults and covers around 60 million Americans 65 and older. It also covers younger individuals who have a qualifying disability or 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, your non-working spouse will also qualify, based on your work record, when they turn 65.

Divorced spouses are also eligible if your marriage lasted at least 10 years, the divorced spouse is unmarried, they are 62 or older, you qualify for Social Security or have a disability, and the benefit they receive based on their own work is less than the one they would receive based on yours. Benefits are also available to surviving spouses who are single and who were married for at least nine months before their spouse passed away.

In addition to Part A, both you and your spouse would also 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 more.

Older Spouses If your spouse is older than you, they can qualify for Medicare based off your work record at 65, even if you are not receiving Medicare yourself – but you must be at least 62. Additionally, you must have been married for at least one year.

If you are still working and your spouse is covered by your employer’s health insurance, they may want to enroll only in the premium-free Medicare Part A until you retire or your employer coverage ends. Part B and 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 more information on this. (Note: If your spouse is funding a health savings account, they may not want to enroll in Part A because they will not be able to make contributions after enrolling.)

Younger Spouses If your spouse is younger than you, they will need health insurance until they turn 65 and become eligible for Medicare. This may be through the Health Insurance Marketplace or, if you are still working, through COBRA.

Other Medicare Choices In addition to Medicare Parts A and B, when you and your spouse become Medicare-eligible, each of you will need to enroll in a Part D prescription drug plan if you do not have credible drug coverage from your employer or union. Additionally, you may want to purchase a Medicare supplemental (Medigap) policy to help pay for things that are not covered by Medicare such as copayments, coinsurance and deductibles. You may also want to consider an all-in-one Medicare Advantage plan.

For more information on Medicare choices and enrollment rules, visit Medicare.gov or call 800-633-4227. You can also get help through your state’s Health Insurance Assistance Program, which provides free Medicare counseling.

“Savvy Living” is written by Jim Miller, a regular contributor to NBC’s “Today Show.” The column, and others like it, is available to read via The American Legion’s Planned Giving program, a way of establishing your legacy of support for the organization while providing for your current financial needs. Learn more about the process, and the variety of charitable programs you can benefit, at legion.org/plannedgiving. Clicking on “Learn more” will bring up an “E-newsletter” button, where you can sign up for regular information from Planned Giving.