Many Americans purchase private health insurance through group plans offered by their spouse’s employer. If this describes your family, it’s understandable that you might expect the same to be true under Medicare. While you may be eligible for some Medicare coverage through your spouse, this is limited to Part A premiums. In this post, we look at the different Medicare parts and what happens when only one spouse qualifies for Medicare.
Are You Eligible for Medicare Part A?
Medicare Part A is the program’s hospital insurance. By the time most Americans turn 65, they qualify for premium-free Part A. If you paid Social Security taxes for at least 10 years or are eligible for Railroad Retirement benefits, you qualify for premium-free Part A.
If you are 65 but do not meet the above requirements, you may still get premium-free Part A if your spouse is at least 62 years old and paid Social Security taxes for 10 years. In addition, one of the following must apply to your situation:
- You’ve been married for 12 months or more AND your spouse is eligible to collect Social Security benefits
- You are divorced now but were married for 10 years or more AND your spouse is eligible for Social Security AND you are single
- You are widowed after being married for at least 9 months AND your spouse was eligible for Social Security AND you are single
You may also be eligible for premium-free Part A if you are under 65 and have End-Stage Renal Disease or a qualifying disability. If you do not qualify for premium-free Part A, you’ll pay $437 per month if you paid Medicare taxes for less than 30 quarters (7.5 years). If you worked 30 to 39 quarters, you’ll pay $240 per month.
Can You Get a Discount on Your Part B Premium?
Even if they get Part A for free, most people pay a monthly premium for their Medicare Part B coverage. And no, there is no family discount (or any other kind of discount). Medicare is a government program, not a private insurance provider.
The standard Part B premium is $135.50 in 2019. However, most people who collect Social Security pay a little less than this, around $130 on average. Your payment may be higher if your income is over $85,000 per year (individual) or $170,000 (married filing jointly).
What If Only One of You Qualifies for Medicare?
It is very common for one spouse to qualify for Medicare before their partner does. If the qualifying partner is also the one whose job provides health insurance, that doesn’t mean that one of you now goes without insurance.
If you are under 65, employed, and your employer offers health insurance, losing your previous coverage qualifies as a life change. This should allow you to sign up for insurance through your employer’s group plan. If you are not employed, you qualify for a Special Election Period as a provision of the Affordable Care Act (ACA).
When looking for a private policy through the ACA website, many people become discouraged because they don’t complete the process. The rate you see quoted when you first begin is the base rate. It nearly always drops (considerably) as you complete the questionnaire and enter income information.
What About Medigap?
Although provided by private insurance companies, your Medigap policy is private, for you only. However, there are some savings available to spouses, often known as household discounts. These vary widely according to the plan and the provider. If you want to learn more, call us toll-free at 855-350-8101. One of our licensed agents can answer your questions and help you find the right Medigap plan.
Can You Contribute to an HSA?
If you have a health savings account (HSA) and your spouse has Medicare, he or she can contribute to your HSA. However, if you have Medicare, the IRS bans contributions into your own health savings account.
Remember, Medicare is not private insurance. As a government program, it doesn’t offer the types of discounts most of us are used to getting when “buying in bulk.” The only time your spouse plays a role in your Medicare coverage is if you need to use their work history to qualify for premium-free Part A.
As always, if you have any questions about your Medicare coverage, our licensed agents are only a phone call away.