Medicare For Non-Working Spouses - How You Can Qualify

By: Edward Neeman
Published: Wednesday, November 07 2018
Last Updated: 8 days ago

Unlike traditional health insurance, you can’t add family members or dependents to your Medicare plan. However, with Medicare, there is still a chance that your spouse can qualify for coverage based on your qualifications.

Your Medicare is based on either your personal work history or the work history of your spouse. Now, it’s important to note that when anyone mentions Medicare Eligiblility, they are generally speaking about being eligible for premium-free Medicare Part A. However, if you meet citizenship, or resident status requirements and are over 65 years old, you will qualify for Medicare. You just may have to pay for both Parts A and B.

Will Medicare Cover Your Non-Working Spouse?

The beneficiaries for Medicare have to get their own Medicare insurance. The individual plans of the Medicare for your spouse must be issued separately from the Social Security Administration. The process for enrollment and eligibility are somewhat different for Medicare Part A. For most, this part of Original Medicare doesn't require any premiums to be paid.

Medicare Part A is defined as the hospital insurance that will be issued as long as you and your spouse have paid the taxes into Medicare while you were actually working. This Medicare tax is also called OASIS tax on your payroll checks issued by your employers.

Premiums for Medicare Part A are calculated by the number of quarters that you or your spouse may have worked over a certain period of time. This means that if you have worked at least 40 quarters or 10 years with an employer that pays into the Social Security System, then premium-free Medicare Part A for your spouse, as well as yourself should be readily available for the both of you.

However, if you or your spouse haven't paid into the Social Security Administration and Medicare System at all, or if you and your spouse haven't worked enough quarters to qualify through both of your work histories, then you will have to pay premiums for both Medicare Part A and Medicare Part B.

What If Your Spouse Has Never Worked?

An employer's payroll deductions pay the OASIS or Medicare taxes that you and your non-working spouse must have in order to qualify for the Medicare benefits. You have to work at least for 40 quarters or 10 years in order for your non-working spouse to qualify when they turned 65. However, if for some reason you become injured on the job or become disabled due to healthcare reasons, your non-working spouse may be able to draw from the disability benefits.

Your non-working spouse should be able to draw 50% of your benefits if they qualify. This would be at the Social Security Administration's sole discretion after the application has been submitted.

Eligibility Requirements

Medicare isn't just for individuals who work their entire lives. In fact, you can draw Medicare benefits for your spouse as long as you both have been US residents that have legally been in the country for 5 years, or if you both are US citizens.

Medicare eligibility for a spouse may also cover you if your spouse is injured at work or has a qualifying disability due to healthcare issues, then Medicare eligibility for a spouse may be granted if you qualify and you could be eligible to draw 50% of your spouse's disability benefits also. You must also meet the standard eligibility requirements:

  • Have End Stage Renal Disease (This is defined as permanent kidney failure that requires a transplant or dialysis).
  • Be 65 years of age or older.
  • Have a qualifying disability and be under the age of 65.

Applying For Medicare Through Your Spouse

If you are divorced or widowed and you don't qualify based upon your own employment history with the Social Security Administration, then you could qualify for Medicare based upon the employment history of your spouse. If you are divorced, then you must have been married for at least 10 years or more.

You must be 65 in order to be eligible for free part A through your prior spouse. Your former spouse must have paid into the Medicare system and worked at least 40 quarters or 10 years.

When Medicare Won't Cover Your Spouse

Medicare spouse coverage will not cover a spouse if they are younger than the required age for Medicare, that is unless they have a disability of some sort. If your spouse doesn't have a qualifying disability, then Medicare spousal coverage will not kick in until you have turned 62 years of age.

Medicare Entitlements for Foreign Spouses

A foreign spouse may draw Medicare spouse coverage benefits from their spouse as long as they have reached 62 years of age and meet the eligibility requirement that includes: 1) Married to you for a least 1 year; 2) They are a permanent resident of the United States, and 3) They are 65 years of age or older.