Does Medicare cover for non-working spouses? Generally, yes.
Medicare is available to almost any U.S. citizen who has been a citizen for at least five years.
However, if you don’t have a work history of your own as a non-working spouse, you may have to pay a premium for Medicare Part A (hospital insurance.)
To get out of the requirement to pay a monthly premium for Part A, you or your spouse must have worked and paid Medicare taxes for at least 40 quarters, which amounts to ten years.
Those 40 quarters do not have to be consecutive to qualify for Medicare.
If you qualify, for benefits based on your work history, your non-working spouse will qualify, too, once he or she turns 65.
In addition to Part A, both you and your spouse would also qualify for Medicare Part B, which covers doctor’s visits and other outpatient services, but requires a monthly premium. The premium for Part B beneficiaries in 2024 is $174.70 per month per person.
Couples filing jointly with incomes over $206,000 per year pay an additional amount under IRMAA rules.
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Divorced Spouses
Divorced spouses are also eligible based on their former spouse’s work history if they were married at least 10 years and currently single.
Widows and Widowers
Widows and widowers who are currently single and who were married for at least nine months before the death of their spouse also qualify for Social Security Benefits based on the work history of the deceased spouse.
Note: Your status as widowed or divorced does not affect your eligibility for the Medicare program in general. But depending on your circumstances, it could affect whether you qualify for premium-free Part A benefits.
Enrollment Considerations
The same initial enrollment period and general enrollment periods that apply to the working spouse also apply to the non-working spouse:
The initial enrollment period starts the first day of the month three months prior to the non-working spouse’s birth month, extends through the birth month, and up until the last day of the third month following the birth month.
Example: You are a non-working spouse who was born in April. Your initial enrollment eligibility period for Medicare starts on January 1st, and ends on July 31st.
Unless you maintain creditable coverage via an employer or other plan in the interim, you may face late enrollment penalties for Part D and Part C.
Joining Medigap, Medicare Advantage, or Medi-Share 65+ as a Non-Working Spouse
Most people don’t just join Medicare Parts A and B and be done with it.
In practice, nearly everyone needs and opts to enroll in some additional protection, via Medigap (Medicare Supplement Insurance) Medicare Advantage (Medicare Part C),or the lesser known but powerful and affordable Medi-Share 65+ health sharing plan.
Each of these are private plans that help you pay out-of-pocket expenses you would otherwise have to pay under Original Medicare (Part A and Part B) alone, such as deductibles, copays, and coinsurance.
Medigap and Medicare Advantage are private insurance companies. Medi-Share 65+ is also private, but it’s a health sharing organization, not an insurance company. But you can enroll in any of these plans, even as a non-working spouse with no work history, provided you qualify for Medicare Part A and Part B.
Medicare Part D – Prescription Drug Coverage
While most Medicare Advantage plans feature a prescription drug benefit embedded in their plans, Medigap and Medi-Share 65+ don’t include prescription drug coverage at all.
It’s a good idea to purchase a Medicare Part D prescription drug plan as soon as you are eligible and sign up for Part B, if you don’t maintain creditable coverage from another plan.
Non-working spouses can enroll in Part D, regardless of their divorced or widowed status. However, again, you may need to pay a late enrollment penalty if you wait too long to enroll.
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Need a hand?
If you need a case analysis and recommendation, don’t hesitate to reach out to one of our expert Personal Benefits Managers.
The process is easy and straightforward. And there’s no charge.
We can go over your situation and see if you or your non-working spouse is likely to qualify for benefits based on the working spouse’s history.
So if you’re not sure if you or your spouse will qualify, we can at least provide you peace of mind.
For Further Reading: Medicare Open Enrollment: What’s it All About? | Medicare Plans That Let You Choose Your Doctor | Medicare When You Work Past 65
Tom Lockwood is a Personal Benefits Manager at MediGap Advisors. Tom has a passion for bringing clarity to those confused about Medicare. He is an authority on Medicare, Medicare supplement plans, Medicare Advantage plans, and Part D prescription drug plans. Read more about Tom on his Bio page.