Will My Medicare Plan Cover My Spouse?

Spouse Medicare Eligibility Criteria

Medicare is a health insurance program for qualified individuals aged 65 and above and people under 65 who meet certain qualifying conditions. While Medicare can provide great coverage for many seniors, it does not provide joint coverage. For your spouse to get Medicare benefits, they must enroll individually whenever they become eligible. However, there are times when your spouse’s eligibility can qualify you to receive certain benefits.


Income and Employment

Your income can affect the premium rate you pay for Medicare. Individuals who have worked and paid Medicare taxes for at least 40 quarters, or ten years, are qualified for premium-free Part A. If your spouse has paid the necessary Medicare taxes, you may still qualify for Part A when you turn 65 even if you do not have the required work history.


To qualify for Medicare Part A benefits based on your spouse’s employment history, there are certain requirements you must meet. First, you must have been married to your spouse for at least one year before they apply for benefits from Social Security. If they qualify for Social Security benefits but you are divorced, you can qualify for Medicare if you were married for at least ten years.


If you are widowed, you must have been married to your spouse for at least nine months before becoming widowed to qualify for Medicare.


In a case where your spouse is older and they do not meet the 40 quarters requirement but you do, your spouse can receive premium-free Part A when you turn 65.


Enrollment Periods

Your first enrollment period is known as the Initial Enrollment Period. This starts three months before you turn 65 and ends three months after turning 65. During this period, you can enroll in Original Medicare if you are eligible. The next enrollment period is known as the General Enrollment Period.


You can enroll during this period if you missed or delayed enrollment during your Initial Enrollment Period. The General Enrollment Period starts on January 1 and ends on March 31. It is important to note that you may face late enrollment penalties if you fail to enroll during your Initial Enrollment Period.