The reassuring aspect of Medicare and Marriage is that your coverage remains unaffected, as does your spouse’s.
Whether you’re already in wedlock, contemplating marriage, or have parted ways, here’s the essential information you should be aware of.
Medicare for Married Individuals
Your Medicare coverage and your spouse’s may start at different times. Medicare operates as an individual plan, meaning there is no option for a family plan. However, you might qualify for Medicare based on your spouse’s work history, even if you don’t meet the eligibility criteria independently. It’s important to note that you and your spouse might not begin your Medicare coverage simultaneously because both of you must enroll separately. The timing of your enrollment could vary depending on your respective ages.
Changes in your total income can lead to adjustments in your premiums.
Medicare does not offer family plans or special rates for couples. Both you and your spouse will individually pay the same premium amount as any other individual enrollee. Here’s what you need to understand about the costs:
Medicare Part A, which covers hospital expenses, is typically free for most individuals who have either worked themselves or have a spouse who is eligible for Social Security benefits. However, other parts of Medicare come with monthly premiums. When it comes to Medicare Part B, providing coverage for outpatient medical services, the premium you pay is determined by your combined income with your spouse. In 2023, the standard premium is $164.90 per month. As your combined income increases, so does the monthly premium you’ll be responsible for.
For Part C, also known as Medicare Advantage, both you and your spouse will have separate premiums, deductibles, and copayments. This applies even if you choose the same Medicare Advantage plan. These plans are offered by private insurance companies and encompass all the services included in Medicare Part A and Part B. Additionally, you may incur an additional premium from the insurance company, in addition to your Part B premium, and you may be eligible for extra benefits such as prescription drug coverage. You may also be required to use healthcare providers within the plan’s network.
Enrolling in Medicare Advantage can typically be done during your initial Medicare eligibility period, which spans seven months starting three months before your 65th birthday, includes your birthday month, and extends for three months afterward. Alternatively, you can enroll during the annual open enrollment period, which runs from October 15th to December 7th each year.
As for Medicare Part D, which covers prescription drugs, plan details and premiums can vary. Even if both you and your spouse select the same plan, each of you will need to meet the plan’s deductible before Medicare begins covering your healthcare expenses. Enrolling in a Medicare Part D plan is typically done during your initial Medicare eligibility period or during the annual open enrollment period, which occurs from October 15th to December 7th each year.
Click here to know more about Medicare Enrollment Periods.
Medicare Eligibility for Widowed or Divorced
Individuals In cases where you do not meet the criteria for free Medicare Part A based on your own employment history, you can still qualify by relying on your former spouse’s work record, even if you are widowed or divorced.
In the event of divorce, it’s necessary to have been married for a minimum of 10 years. Once you reach the age of 65, you become eligible for complimentary Medicare Part A through your former spouse, provided they worked for at least a decade and made Medicare tax contributions during that period.
The application for Medicare can be completed online or through your local Social Security office. You can begin the process three months prior to your 65th birthday, in the month of your birthday, and for an additional three months following your birthday month.
However, it’s important to note that you will still be responsible for paying premiums for the other components of Medicare coverage, as detailed earlier
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