Medicare isn’t just for retired workers. You, including your spouse, can get Medicare if you belong to the US with valid citizenship or legal residency for at least five years and meet the eligibility requirements.

In short, your non-working spouse can apply for Medicare if they are eligible. First, however, we would like to go into this in more detail. So let’s begin with eligibility rules.

Medicare Eligibility Rules

Medicare, the government’s health insurance program for older adults, covers more than 55 million Americans age 65 and older, as well as youth with a qualifying disability or with end-stage renal disease.

To qualify, you must have paid Medicare taxes for at least ten years to qualify for premium-free Medicare Part A hospital coverage at age 65. If you qualify, your non-working spouse will qualify, too, based on your work record when they turn 65.

Additionally, divorced spouses are eligible if they were married for at least ten years and are single. To be eligible, a single surviving spouse has to be married for at least nine months before their spouse dies.

In addition to Part A, you and your spouse will also be eligible for Medicare Part B, which covers doctor visits and other outpatient services but requires a monthly premium, irrespective of the work history.

You should be aware of several other caveats when signing up for Medicare for your non-working spouse. The significant one is spouse age. We have discussed it in detail below.

Medicare If You Have a Non-Working Older Spouse

If you have a spouse older than you, they may qualify for Medicare on your work record at the age of 65, even if you are not getting Medicare yourself, but you should be at least 62 years old. You must also have been married for at least one year for your spouse to claim Medicare on your work record.

If you’re still working and your employer’s health insurance covers your spouse, they may want to enroll in non-premium 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 crucial coverage. Check with your employer’s HR department to find out more about it.

If your spouse is 3+ years older than you and doesn’t have any health insurance, you can buy her Medicare Part A (with premium) until you turn 62 and non-premium benefits begin.

Medicare If You Have a Non-Working Younger Spouse

Unless you and your spouse have the same birth year and month, one of you would be eligible for Medicare earlier than the other. 

However, if you’re both covered by your employer’s health insurance, and one of you turns 65, you’ll need to make a Medicare decision. In this case, it would depend on the employer and its rules regarding covered Medicare dependents. For example, some employers may require a Medicare-eligible spouse to enroll in Medicare to remain on the employer plan.

Case I: If your spouse is younger, irrespective of their age, and you are still working past 65, then your employer’s plan may cover your spouse until they hit the eligibility criteria or turn 65.

Case II: If you’re retired and enrolled in Medicare, you have to choose temporary health insurance for your spouse until they become eligible for Medicare. 

You can opt for other insurance through COBRA or the health insurance marketplace. In addition, you can choose to work, if possible, until your spouse turns 65 to stay covered under the employer’s plan.

Medicare Advantage Plans for a Non-Working Spouse

If you and your spouse are eligible for Medicare Part A and Part B, you are likely to qualify for a Medicare Advantage plan.

Medicare Advantage plans offer the same benefits as Medicare Part A and Part B. Some Medicare Advantage plans also offer additional benefits such as prescription drug coverage and provision for dental, vision, and hearing care.

Call today to speak with our licensed insurance agent to learn more about Medicare Advantage plans for yourself and your spouse.

Note: Try to enroll in Medicare Part D (a prescription drug plan), if you have an Original Medicare, during your Initial Enrollment Period to avoid penalties. If you already have drug coverage, you must register in Part D within 63 days after your other coverage ends to avoid penalties.

Some Common FAQs for Your Spouse’s Medicare

Q. Can I get Medicare if I have never worked before?

Even if you have never worked in your life, you are eligible for Original Medicare if; 

(i) you have a valid US citizenship or legal residency for at least five years or have turned 65, or

(ii) are disabled/suffering from end-stage renal disease.

However, you can qualify for a premium-free Part A if you or your spouse has paid Medicare taxes for at least 40 quarters. Notably, these 40 quarters don’t need to be consecutive.

Q. How can my Spouse sign up for Medicare?

If eligible and not receiving Social Security benefits, your spouse can sign up manually by visiting their local Social Security Office. You can also contact SSA (Social Security Administration) at 800-325-0778 first and confirm your or your spouse’s eligibility.

Q. Can I get my Spouse covered on my Medicare Plan?

No. Many individuals mean to ask whether they can get their spouse enrolled in their Medicare plan when asking whether their spouse can get Medicare. Medicare is an individual program, and each individual has to enroll in it separately – even if it’s your spouse.

As we know, some of the above information can be overwhelming and confusing, and our experienced and licensed brokers can help you through Medicare enrollment.

At Simple Horizons, we have years of experience helping people find and apply for the right Medicare plan. We can help you choose a plan that covers the medical services you need. Our licensed agents specializing in Medicare at Simpler Horizons will help you choose the plan that best suits your medical needs and finances.

Let us help you find a suitable Medicare plan for you. Contact us for more information!