Do I need Medicare if I’m covered by my spouse’s insurance?

For many, Medicare eligibility begins at 65, because it is a program for people of age 65 and older. But for some, the enrollment process for Medicare may be delayed. Why is that? Well, some individuals may already have a source of reputable health care coverage that allows them to delay enrolling in Medicare once they become eligible. For example, some individuals choose to delay enrollment if they are currently covered under their spouse’s medical insurance.

While it’s good that you have current healthcare coverage with your spouse’s insurance plan, you should also keep in mind the future possibilities that could require you to get more extensive coverage, such as possible health risks. That’s why it may be worth looking into your own healthcare plan, such as Medicare.

How do I qualify for Medicare?

Whether or not you are married, you are eligible for Original Medicare when you turn 65 or receive Social Security Disability benefits. However, you will need to confirm with your spouse’s plan if they require you, a covered dependent, to still enroll in Medicare when you become eligible.

Also, Medicare does not consider domestic partners as spouses, meaning if you delay enrolling in Medicare because you are covered under your partner’s plan, you would be subjected to late enrollment penalties. In other words, in that situation, you will not be eligible for the Special Enrollment Period, and continuously, you will be exposed to a late enrollment penalty, no matter which Medicare part you want to enroll in. If you live in a domestic partnership, it would be best to enroll in your own health insurance plan as soon as you become eligible, rather than rely on your partner’s policy.

What are my options?

If you are covered by your spouse’s health insurance plan provided through their current employment, the moment when you become eligible for Medicare enrollment, you will have a few options:

  • You can enroll in Medicare as soon as you become eligible: The Initial Enrollment Period is a personalized period for you to enroll in Medicare once you are eligible. It begins three months before your 65th birthday and lasts up to three months after your 65th birthday. During this period you are required to enroll in Medicare if you do not want to be exposed to a late enrollment penalty fee for a period of time you was eligible to enroll but failed to.
  • You can enroll only in Part A as soon as you become eligible: For many, Part A does not require a premium payment (if you have been working and paying Medicare taxes for at least 10 years). However, Part B always will require a monthly premium. If you want to avoid the Part B premium, you can enroll in Part A and delay your Part B coverage, but have in mind in that case that you will be subject to a late enrollment penalty fee for as long as you have Medicare Part B.
  • You can delay enrolling in Medicare until you lose coverage: Because your current coverage is under your spouse’s employment-based health plan, you can avoid paying late enrollment periods when you need to sign up for Medicare. You will be eligible for an 8-month Special Enrollment Period.

Be sure to call Medicare and your spouse’s insurance company for additional details about health coverage options. Medicare will help you answer specific questions about the situations described above, as well as Social Security.

If you have any other questions or concerns, give Temmen Insurance Inc. a call at 417-633-7200.

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