Marital status and Medicare eligibility
When it comes to your personal benefits, getting married seems to give you an advantage for things like car insurance and home ownership. However, with health insurance and Medicare coverage, you might not know how your marital status can impact how much you pay and your eligibility for certain health care benefits.
Does getting married affect my Medicare eligibility?
No, getting married does not affect your eligibility for Medicare or Social Security benefits. Any person who has paid into the Medicare system as part of their employment for the equivalent of 40 credits, or about 10 years, of work is eligible to receive full Medicare benefits at the age of 65. Medicare Part A does not require a premium and is free to eligible seniors. The rule is applied to any U.S. citizen or resident, regardless of marital status.
If you did not work and reach the required credits for Medicare eligibility, you may still be qualified for Part A under your spouse's Medicare plan so long as he or she is 62 or older and has earned 40 credits. The same rule has yet to be clarified for same-sex married couples and eligibility may depend on your place of residence. For example, you will be eligible for Part A if you live in the same state where you were married; if you live in another state or the District of Columbia where same-sex marriage is legal and the state recognizes the laws of other states or a foreign country; or if your spouse works for the federal government or for the U.S. Department of Defense in a civilian or military job.
Currently, the Supreme Court allows states to refuse to recognize same-sex marriages performed in other states, which means a spouse's eligibility for Medicare could be refused depending on where you live. If a spouse is unable to qualify for Medicare Part A – the free part of Medicare that covers hospital visits – they may purchase coverage for a monthly premium.
Medicare while married
If you are already married and both you and your spouse have reached the Medicare eligibility age, you may both have your own plan. It is likely that you and your spouse won't become eligible at the same time, so you will each enroll separately.
When it comes to the cost of Medicare plans, there are no special rates for married couples, and premium prices are based on the total income earned between you and your spouse. While Medicare Part A enrollment requires no cost for eligible participants or their spouses, Part B premiums – which cover doctor services, medical equipment and outpatient care – are based on income. This can mean that the more you make, the more you will pay for Part B benefits.
If you and your spouse sign up for Medicare Part C,or Medicare Advantage, you will both have your own copay, deductible and premium. This is true even if you both enroll for the same plan. The same is also true for Part D prescription drug coverage plans and both you and your spouse must meet the deductible amount before Medicare will begin to cover the costs.
Single, Divorced or widowed
If you're a single person who has never been married, your Medicare eligibility will depend on how many credits you earned while working. If you have earned the 40 required credits, you will become initially eligible to enroll in Medicare three months before your 65th birthday. You may qualify before you turn 65 in some circumstances such as if you have been receiving Social Security disability benefits for at least 24 months; you receive disability from the Railroad Retirement Board; you have permanent kidney failure or you have Lou Gehrig's disease.
If you are divorced or widowed, you may still be eligible for your spouse's Medicare benefits if you were married for at least 10 years and your spouse earned Medicare credits or if your late spouse worked for at least 10 years paying Medicare taxes.
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