Question: Your questions often relate to Social Security benefits for spouses, especially lower income-earning spouses, or spouses who have not worked. Does Medicare have similar considerations? I have worked all my life. My spouse worked for a few years and then cared for our children. Will he be eligible for Medicare?~~ Carrie
Answer: There are plenty of families in your situation when it comes to applying for Medicare, the government insurance program that covers more than 55 million Americans age 65 and over and those with certain disabilities. The answer generally is yes, your spouse can qualify for Medicare on your work record. Keep in mind, though, that Medicare is complex and “there are always ifs,” said Patricia Barry, author of “Medicare for Dummies.”
First, a step back: What we’re talking about when we say “qualify for Medicare” is eligibility for Medicare Part A hospital coverage, which is free to workers who have worked long enough to qualify for Social Security retirement benefits. To meet that requirement, you must earn at least 40 credits during your working life, or the equivalent of about 10 years of work. (Those receiving Social Security disability payments may also qualify.) Spouses of eligible workers are also covered, as well as divorced and surviving spouses who meet certain conditions. But people without the required work history must pay up to $411 per month for Part A premiums.
For anyone who is eligible for Medicare Part B, which covers doctors’ visits and other outpatient services, requires a premium, not a work history. Most beneficiaries pay premiums of $134per month (2017 rate), while new beneficiaries and higher earners pay more.
Now, here are some “ifs” that might affect your particular situation. To qualify for premium-free Part A, your spouse must be 65 or older, and you must be at least 62. If you are under age 62, he must pay Part A premiums until you reach that age.
Also, you must have been married for at least one year for him to apply for Medicare on your work record. This requirement applies to married same-sex couples as well, who are eligible to apply for benefits on their spouse’s record.
To sign up, you can go to Medicare.gov—you can find enrollment tips here. Be sure to request a quote for Part D drug coverage too, as well as a Medigap plan by clicking here. Or you may want to consider an all-in-one Medicare Advantage plan.
Question: I received a letter from the Social Security Administration saying that because my income for 2015 was above the limit of $85,000, will I pay an additional Medicare Premium of $53.50 per month for Medicare Part B?
Q: I’m turning 65 and have signed up for Medicare Part A. I plan on working at my company for the next two years. It offers group health insurance that is primary to Medicare. Is there an advantage to enrolling in and paying for Medicare Part B or am I better off declining Part B and signing up for it when I retire from my employer? –John
For most people, turning 65 means you’re eligible for Original Medicare, Part A and Part B. This federal program provides hospital insurance and some medical insurance to older Americans and those under 65 with certain disabilities.
At this time, you may also choose to enroll in Medicare Part C, also called Medicare Advantage. These plans are available from private insurance companies and must offer the same benefits as Part A and Part B, but may add more coverage such as vision, dental, or prescription drug benefits. Or you could add a stand-alone Medicare prescription drug plan to your Original Medicare to receive prescription medication coverage. Medicare Supplement insurance (called Medigap) is also available to add to your Medicare coverage and help cover the “gaps” in Original Medicare.
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If you’re among the 7 million Americans enrolled in the Qualified Medicare Beneficiary (QMB) Program, providers aren’t allowed to bill you for medical services and items that Medicare covers. This means you can’t be billed for Medicare deductibles, coinsurance, and copayments.