Medicare coverage for non-working spouses

Published by Medicare Made Clear®


Can a non-working spouse qualify for Medicare?

Medicare isn’t just for people who retire after many years of working. Anyone who meets Medicare eligibility requirements can get Medicare, including spouses. But when a person asks “Can my non-working spouse get Medicare?” they really are asking “Can my spouse be on my Medicare plan?”

The answer is no. Medicare is individual insurance, so spouses cannot be on the same Medicare plan together. Now, if your spouse is eligible for Medicare, then he or she can get their own Medicare plan.

But, what’s interesting is that there are some things to think about in regards to your non-working spouse and Medicare.

Can your non-working spouse get premium-free Medicare Part A?

Yes! If you worked and paid Medicare taxes through payroll deductions for at least 10 years, then you and your spouse will both for premium-free Medicare Part A at age 65. There’s no premium for it because your Medicare tax dollars go into the hospital insurance trust fund, which then finances Medicare Part A benefits for eligible individuals.

What happens if one of you becomes eligible for Medicare before the other?

Unless you and your spouse were born in the same month of the same year, one of you will become eligible for Medicare before the other. If you both are covered by your employer health insurance, and one of you turns 65, you’ll have decisions to make about Medicare. In this case, it will depend on the employer and their rules around covered dependents of Medicare age. Some employers may require spouses who are eligible to get Medicare to do so at age 65 in order to remain on the employer plan.

You can learn more about your potential options by talking with your employer benefits administrator.

Medicare when your non-working spouse is younger

You’ll need to make some decisions about Medicare when you become eligible, whether or not you continue working past age 65.

Either way, your spouse will need health insurance until he or she is also eligible for Medicare. Here are some of the options:

  • Your spouse may continue coverage through your employer plan if you keep working and keep the employer coverage.
  • Your employer may offer COBRA coverage for your spouse if you retire.
  • Your spouse may choose to buy individual health insurance until he or she turns 65.

Your employer benefits manager can help you and your spouse understand your choices.

Medicare when your non-working spouse is older

If your older spouse is covered by your employer health insurance, they may want to enroll only in premium-free Medicare Part A until you retire or your employer coverage ends. Part B—along with its premium—can be added later without penalty during a Special Enrollment Period as long as your employer provides creditable coverage.

It’s important to note that your age, as the working spouse, will affect when your non-working spouse qualifies for premium-free Medicare Part A. You must be at least 62 years old and eligible for Social Security benefits before your spouse can enroll, because his or her qualification is based on your work record. You don’t have to actually start getting your Social Security benefits; you just need to be old enough to file for them if you wanted to. If you are younger than 62, your spouse may choose to pay the premium for Medicare Part A, if needed, until the premium-free benefit kicks in.

Medicare may be individual insurance, but spouses should think about the above things when helping each other with Medicare decisions.

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Medicare Made Clear brought to you by UnitedHealthcare provides Medicare education so you can make informed decisions about your health and Medicare coverage.

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