Senior Healthcare: Do I Have to Sign Up For Medicare if I Am Covered by My Spouse’s Insurance?

medicare with spouse's insurance

Turning 65 is a big moment. But, if you aren’t retiring, you’re at least considering the big life questions like where you want to spend your retirement and what quality of retirement you can afford. Not least of these questions is, “Do I have to sign up for Medicare if I am covered by my spouse’s insurance?”

A whole new set of rules apply when you’re a Medicare-eligible senior, and adjusting your mindset to the Medicare options available can be challenging. So here’s what you need to know when you’re eligible for Medicare but covered by your spouse’s employer-provided health insurance.

Do I have to sign up for Medicare if I am covered by my spouse’s insurance?

No, you don’t have to sign up for Medicare if your spouse’s employer-provided health insurance already covers you. You can stay on that plan as long as your spouse is employed.

But remember, Medicare is a plan only for individuals and doesn’t provide coverage for spouses. So when your spouse retires and signs up for Medicare, you’ll have to enroll separately. So it’s a good idea to decide what your individual insurance plan is or will be.

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What are my options if I’m eligible for Medicare but currently covered by my spouse’s insurance?

When you turn 65 and are covered by your spouse’s employer insurance, you have several Medicare options. Here’s what you can do to ensure you have the coverage you (and your spouse) need.

Option 1. Drop your spouse’s insurance and enroll in Medicare

You might decide to drop your spouse’s employer insurance and enroll in Medicare. Another option is to enroll in Medicare Parts A and B, the Medicare Part D prescription drug plan, or Medicare Advantage (Part C). You can also enroll in Medicare supplement plans.

Dropping your spouse’s coverage and enrolling in Medicare is an excellent option if you have personal health concerns that are covered by Medicare Part B, D or Medicare Advantage.

If you choose to enroll in Medicare when you turn 65 despite your spouse’s employer insurance, make sure to sign up during your Initial Enrollment Period (IEP). Your IEP begins the month of your 65th birthday and ends three months later.

Option 2. Keep your spouse’s insurance and enroll in Medicare Part A 

Suppose you delay dropping your spouse’s employer insurance. In that case, you can still enroll in Medicare Part A. Medicare Part A has no premium, so it’s an excellent supplement to your spouse’s employer benefits.

As a spouse, you can wait to sign up for Medicare Part B without incurring the late enrollment fee. Instead of enrolling when you turn 65, enroll during the Special Enrollment Period (SEP), which is available only to married individuals. The SEP begins after losing your spouse’s employer-provided health benefits and lasts eight months.

Option 3. Keep your spouse’s insurance and enroll in Medicare later 

You can always simply stay on your spouse’s employer insurance and sign up for Medicare when your spouse retires. Delaying enrollment can be a good option. If you’re satisfied with your spouse’s employer insurance benefits, delaying enrollment can be a good option. Just make sure you don’t need to access any of the other benefits—such as hospice care—that Medicare provides.

As with waiting to sign up for only Medicare Part B, you can delay your enrollment in all Medicare benefits until your SEP. 

Although you don’t have to sign up for Medicare if you already have coverage through your spouse, you should take time to weigh your insurance options. Feel free to call us at 877.255.6273. We’re happy to help with these important healthcare decisions.