How Does Medicare Work for Married Couples?

As you grow older, you will experience firsthand the need for medical insurance. You become more susceptible to numerous health issues, and the best thing you can do is to have your coverage plan in check. Medicare is a government insurance program aimed towards people above the age of 65 or younger ones with disabilities. Other people who can benefit from this program are those who suffer from permanent kidney failure. While Medicare caters to a small segment of the population, many people wonder how it works for married couples.

If you or your spouse have questions about Medicare, check below to understand more about it for married couples:

Does Medicare Accommodate Spouses?

Medicare is an individual medical coverage plan, which means that you cannot have your spouse join in a family plan if he/she is not eligible as per the previously mentioned conditions. Each of you will have to pay a separate premium just like any other individual looking to benefit from Medicare. That is exactly the reason why supplementary plans targeting to fill the gaps in the original Medicare are becoming widely popular. Medigap is a plan provided by private insurers, as explained on https://medicarewire.com/medigap/medicare-supplement-plans/what-is-the-average-cost-of-supplemental-insurance-for-medicare/, you will find different types of this plan depending on the level of coverage you are seeking. However, you will also find that each plan addresses a specific issue like the ability to pay the premium and the insured person’s current health condition. As you would expect, the more coverage you seek, the more expensive the plan will cost. 

How Will Being Married Affect Your Medicare Plan?

There are no special rates under Medicare for married couples; however, being married will affect how the cost is calculated. There are three parts, or levels, of Medicare, namely Part A, B, and C. The most basic, Part A, will not require you to pay any premium. It covers hospital expenses if you or your spouse have a valid social security number. Skilled nursing and hospice services are also included under Plan A. Part B have to do with medical expenses, which covers certain doctor’s expenses and medical supplies. The premium under Part B is calculated as per the aggregate income both you and your spouse earn annually. The higher your income, the higher is the monthly premium that you will have to pay. As for Part C, also known as “Medicare Advantage”, is a collective plan that includes both parts A and B. It is usually provided by private insurers and might require you to pay for yet another premium in exchange for more benefits like drug expenses’ coverage. According to the health condition and individual needs of each one, you and your spouse will get to choose the right Medicare Part. It is worth mentioning, however, that some private insurers will offer a couples’ discount for spouses who opt for the same plans under Part C or Medicare Advantage. If budget is your priority, take a look at Cigna Medicare Advantage plan offerings. They provide several affordable options, including a large number of low and $0 monthly premium plans, with competitive benefits and prescription drug coverage.

How Does Being Married Affect Your Eligibility for Medicare?

No matter the reason for your eligibility for Medicare, being married will not affect your medical insurance coverage. You can continue to receive your Medicare benefits regardless of the status of your spouse, whether he/she works or not. If, however, you reach the age of retirement and receive retiree health benefits from your ex-employer, your spouse may continue being covered based on that basis only. 

Is it better to Benefit from a Spouse’s Private Plan or to apply for Medicare?

Once they reach the age of 65, spouses usually try to figure out whether it is better to remain under their spouse’s employer insurance and postpone applying for Medicare, or opt-out and apply for Medicare right away. Having two insurance providers at the same time can be tricky. You will need to decide which of the plans are going to be primary and which are secondary. If your current insurance plan offers more benefits and covers more than what a part B Medicare would cover, then you can wait until your spouse’s employment ends. You will then have eight months to apply for Medicare to avoid being stuck paying a permanently higher premium. In a different scenario, if you have private insurance provided by your spouse’s employer, but the employer has less than 20 workers, then it is better to apply and make Medicare your primary insurance. Many factors come into play when deciding whether to delay or apply to Medicare once eligible.

Although Medicare does not provide special benefits to married couples, it does, however, affect the type of private insurance they need to seek. Since Part A is basically free and anyone can benefit from it, the timing of application for Part B Medicare is what you will need to think about. It can be a rather complicated matter, so it is better if you can consult professional insurance advisors to make the best out of your medical plans.