American citizens – 65 years of age and over, or permanently disabled – can avail federal health insurance through Medicare, however, there is no specific clause stating that it will cover spouses as well. Still, there are some cases where a spouse might qualify depending on their partner’s work record. Partners of the 65 years and above age bracket with their own individual work and tax record may be eligible to receive health coverage through Medicare, while those without this option can qualify based on the work record of their enrolled spouse. Below is a detailed discussion on the eligibility criteria for a Medicare enrollee’s spouse, partners, and dependents.
Medicare Coverage for a Spouse
The spouse of an individual who happens to be covered through Medicare can be considered eligible by the time they attain 65 years of age, even though they might not have been part of the workforce. The spouse becomes eligible based on the work record of their spouse.
In case a spouse is disabled, they might be considered eligible at a younger age. In situations where the couple has divorced, after staying married for a minimum period of 10 years, Medicare can take into account the work record of their former spouse. They can then qualify as a divorced or separated spouse who has not ever gone out of their homes to work.
However, they would have to meet certain requirements of age or be suffering from a disability. This condition is applicable only for people who have not remarried, in which case the work record of their new spouse will be taken into account for eligibility. Unmarried and married partners don’t get the same kind of benefits from Medicare.
Social Security Work Credits
If an individual or their spouse wants to attain eligibility for health coverage under Medicare, they require Social Security credits throughout their period of employment. Medicare credits and Social Security work credits are interlinked. As of 2020, a working individual is entitled to receive one work credit for every $1410 they rake in and four credits can be earned in a year.
Those who are self-employed can also receive four work credits every year (one work credit per $1410). Any individual born after 1929 will be considered eligible if they have at least 40 work credits, and even this restriction is lifted for people born before 1923. Qualifying credits for disabled people would depend on the age at which they became disabled. If a person becomes disabled between the 31st and the 42nd year of his life, he or she would require 20 work credits to qualify for disability benefits under Social Security.
Someone who is disabled at 62 must-have 40 work credits to qualify. With all that being said, one must remember that not all types of employment guarantee Social Security work credits. If a spouse happens to be employed with a local or state government that isn’t a participant in Social Security, no credits will be rewarded.
Age Gaps Between Spouses
When one married partner reaches the age of 65 and qualifies for Medicare while the other is still younger, it’s time for spouses to decide upon the next steps. If the older partner becomes eligible for health benefits under Medicare but decides to continue working, their health coverage is still provided by the health insurance they receive from their employer.
In case the older spouse decides to take retirement from work at 65, there are several options for the younger partner for a health insurance policy. However, in most cases, they wouldn’t qualify for health coverage under Medicare till they attain the age required for eligibility.
Medicare Part B
While Medicare Part A refers to hospital insurance, people receive medical insurance under Part B as well. Those who have the optimum number of Social Security work credits required to qualify need not pay anything for Part A, but a monthly premium has to be paid for Part B. If a spouse is 65-years-old and their partner is still covered under the employer’s health insurance, the person who isn’t covered under Medicare might have to wait to get enrolled for Part B. If they decide to sign up for Medicare at the time of a Special Enrollment Period (SEP), they wouldn’t have to shell out a late enrolment fine.
People who have attained the eligible age or come from a medical background can qualify for Medicare using the Social Security work credits of their spouse.