Medicare for Non-Working Spouses: Eligibility and Benefits Explained

Medicare is health insurance for individuals who are 65 years old or older. Some younger spouses with disabilities may also become eligible for Medicare. But how does this work for a non-working spouse? Can they get Medicare if they haven’t worked? The answer is yes! A spouse may qualify for premium-free Medicare Part A if their working spouse paid Medicare taxes through payroll deductions for at least 10 years.

Understanding Medicare eligibility for non-working spouses is important for retirement planning. If you need help choosing the right Medicare plan, contact Bourgeois Insurance at (985) 803-8999 in Thibodaux, Louisiana.

Eligibility Criteria for Non-Working Spouses

Work History Requirement

·        A spouse is eligible for Medicare if their working spouse has paid Medicare taxes for 40 quarters (10 years).

·        If the spouse must pay Medicare taxes, they may still be eligible for Medicare benefits but might need to pay a premium for Medicare Part A coverage.

 Age and Marriage Requirements

·        A non-working spouse must be at least 65 years old to qualify for Medicare at age 65.

·        If a spouse is older, they can qualify for Medicare Part A and Part B once they reach age 65, even if their working spouse has not yet turned 65.

·        If the couple is divorced, the marriage must have lasted 10 years for the spouse to qualify for Medicare coverage benefits. 

Disability Considerations

·        A non-working spouse may be eligible for premium-free Medicare Part A before age 65 if they receive Social Security benefits for a disability.

·        If a spouse has a disability, they can enroll in Medicare Part A and Part B after receiving Social Security Disability Insurance (SSDI) for 24 months.

Types of Medicare Benefits for Non-Working Spouses

Medicare Part A (Hospital Insurance)

·        Premium-free Medicare Part A is available if the spouse’s work history includes paying Medicare taxes for 40 quarters.

·        If the spouse must pay original Medicare Part A premiums, the cost depends on how long their working spouse paid Medicare taxes.

·        Medicare premium-free part Part A benefits cover hospital stays, skilled nursing care, hospice care, and limited home healthcare.

Medicare Part B (Medical Insurance)

·        Medicare Part B coverage requires a monthly premium for Medicare Part B, which is $185 in 2025.

·        A younger or older spouse must pay a higher Part B premium if their income exceeds a certain limit.

·        Enroll in medicare part b? Enrollment in Part B can be delayed without a late enrollment penalty if the spouse has creditable coverage through an employer’s plan.

Medicare Advantage and Medigap Plans

·        A Medicare Advantage Plan (Part C) offers additional benefits like vision, dental, and hearing coverage.

·        A Medicare Supplement Insurance Plan (Medigap) helps pay out-of-pocket costs not covered by Original Medicare.For personalized guidance, contact Bourgeois Insurance at (985) 803-8999 in Thibodaux, Louisiana.

Enrollment Considerations

Initial Enrollment Period

·        The Initial Enrollment Period begins three months before turning 65 and ends three months after.

·        A spouse must sign up for Medicare within this time to avoid penalties.

Special Enrollment Periods

·        A spouse may qualify for Medicare during a Special Enrollment Period if they had employer-sponsored health insurance.

·        Delaying enrollment in Medicare Part B without creditable coverage results in penalties.

Late Enrollment Penalties

·        If a spouse does not enroll in Part B when first eligible for Medicare, they may pay a late penalty.

·        The penalty for delaying enrollment in Medicare Part B is added to the monthly premium for Part B coverage.

 Planning for Healthcare Coverage

Employer Coverage Options

·        If the working spouse continues working past age 65, the younger spouse may remain on the employer’s health plan.

·        COBRA coverage allows a non-working spouse to continue employer health insurance if the working spouse retires.

Individual Health Insurance

·        A spouse may need individual health insurance until they become eligible for Medicare.

·        Some non-working spouses enroll in Medicare Part A and Part B while keeping private health coverage for additional benefits.

Conclusion 

A spouse is eligible for premium-free Medicare Part A if their working spouse paid Medicare taxes through payroll deductions for at least 10 years. Meeting Medicare eligibility requirements allows a non-working spouse to qualify for Medicare benefits at age 65.

Contact Us

Don’t wait! If you or your spouse must sign up for Medicare, get expert guidance today. Call Bourgeois Insurance at (985) 803-8999 to learn about Medicare Part A benefits, Medicare Part B coverage, and Medicare Supplement insurance plans!