Medicare is an individual insurance system, but there are times when one spouse’s eligibility may help the other receive certain benefits.
Also, the amount of money you and your spouse make combined may affect your Medicare Part B insurance premiums.
Keep reading to find out how you or your spouse may be able to qualify for Medicare based on work history and age.
Medicare is a benefit for individuals who worked and paid Social Security taxes for at least 40 quarters of work, which is roughly about 10 years.
If a person’s spouse didn’t work, they may still qualify for Medicare Part A based on their spouse’s work history when they turn age 65.
Rules for Medicare eligibility based on spouse’s work history
To qualify for Medicare Part A benefits at age 65 based on your spouse’s work history, you must meet one of the following requirements:
- You have been married to your spouse who qualifies for Social Security benefits for at least 1 year before applying for Social Security benefits.
- You are divorced, but were married to a spouse for at least 10 years who qualifies for Social Security benefits. You must now be single to apply for Medicare benefits.
- You are widowed, but were married for at least 9 months before your spouse died, and they qualified for Social Security benefits. You must now be single.
If you aren’t sure you meet a certain requirement, you can contact the Social Security Administration by calling 800-772-1213. You can also visit Medicare.gov and use their eligibility calculator.
The spouse’s benefits apply specifically to Part A of Medicare (keep reading for an explanation of what all of the parts cover).
You can’t purchase couple’s coverage for any other portion of Medicare. You must pay for the other individual portions on your own policy.
However, it’s important to consider all of your options for Medicare coverage and what will work best for your needs. One of these options is Medicare Advantage (Part C), which bundles both Part A and Part B together and offers additional coverage and benefits.
If extra coverage, like dental, vision, or hearing care, is important to maintaining your individual health, give some thought to whether original Medicare or Medicare Advantage will work best for you.
Medicare offers its Part A coverage to eligible spouses of enrollees. Services covered under Medicare Part A include:
- inpatient hospital care
- inpatient mental health services
- inpatient rehabilitation services
- hospice care
- limited home healthcare
- limited stays in a skilled nursing facility
There are specific rules about the services and supplies Medicare Part A covers, as well as how long they’re covered.
If a nonworking spouse is older than you, and they meet the 40 quarters requirement
If your spouse is older than you, they’ll qualify for Medicare benefits at age 65.
You may be able to receive Medicare benefits slightly earlier if you’re at least 62 years old, married to someone who is age 65, and also worked for 40 quarters and you paid Medicare taxes.
If you don’t meet these requirements, you may be able to qualify for Medicare Part A, but you’ll have to pay the Part A premium until you’re age 62.
If you didn’t work or meet the 40 quarters requirement, you may have to wait until age 65 to receive coverage under your spouse’s benefits.
If a nonworking spouse is older than you, and you meet the 40 quarters requirement
Now let’s look at when your spouse is older than you and your spouse didn’t meet the 40 quarters requirement, but you do.
When you turn age 62 and your spouse is age 65, your spouse can usually receive premium-free Medicare benefits.
Until you’re age 62, your spouse can receive Medicare Part A, but will have to pay the premiums if they don’t meet the 40 quarters of work requirement.
Most considerations for Medicare and spouses are surrounding Medicare Part A, which is the insurance portion that covers hospital visits.
The other portions are available when an individual turns age 65 and agrees to pay the insurance premium.
If you have further questions about Medicare benefits, you can call the Social Security Administration (SSA) at 800-772-1213 or visit your local SSA office for more information.