When a primary insurance holder retires, there can be questions about how insurance will be provided for their spouse and dependents. If your spouse is too young to qualify for Medicare, learn about your options.
When Do You Qualify for Medicare?
Generally speaking, you qualify for Medicare when you turn 65.
However, in some situations, you could qualify for Medicare at a younger age. Specifically, if you have a medical condition that qualifies you for Social Security disability, such as end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) then you may qualify for Medicare as well. Each of the above listed medical conditions has their own waiting period.
These are the only opportunities that you have to qualify for Medicare.
Do You and Your Spouse Need To Qualify for Medicare To Retire?
No. You can retire any time. However, the earliest that you can draw Social Security retirement is age 62. There are a number of drawbacks to retiring before your full retirement age. One of the drawbacks of early retirement is that you may be too young to access Medicare, and the cost of health expenses without Medicare support could chip away at your retirement savings.
What Happens if You Qualify for Medicare, but Your Non Working Spouse Is Younger?
You have options if you reach age 65 and qualify for Medicare, but your spouse or dependents are not eligible. The best option depends on what your plans are after qualifying. Consider your options:
- You can keep working
- Your spouse and dependents can continue work insurance under Continuation of Health Coverage (COBRA), although likely at a high cost
- Your spouse and dependents can select an insurance plan on the Health Insurance Marketplace
In most cases, unless you stop working, you are not required to take Medicare at age 65 unless your employer has less than 20 full-time employees. This is known as the Small Business exemption.
What are your non working spouse’s health insurance options if you continue working?
If you continue to work and turn 65, you are not required to sign up for Medicare unless your employer requires you to do so. Instead, you can continue to carry your family’s health insurance as normal.
You also don’t lose your Medicare eligibility because you would qualify for a Special Enrollment Period (SEP) after you drop your work insurance from retirement.
What are your non working spouse’s health insurance options if you retire?
If you opt to retire and join Medicare at 65, there are a number of solutions available for your spouse:
- COBRA: You can pay for your work insurance under COBRA for 18 to 36 months after you become eligible for Medicare. However, your monthly payment will go up if your former employer subsidized some of the cost.
- Health Insurance Marketplace: You can buy individual coverage from the marketplace if your spouse loses insurance when you retire and opt not to use COBRA. You can apply for coverage under a SEP.
Do You Have to Sign Up for Medicare at 65 if Your Working Spouse Is Younger?
If your younger spouse is working and has insurance available to them through their job, you can sign up for their plan. Check with their employer to see what steps need to be taken to make the process as smooth as possible.
You should weigh your options strongly when doing this to ensure that you’re getting the best coverage for you at the most competitive rate possible. Usually, this is under your spouse’s work plan because the employer pays a significant portion of the costs.
Learn More From Our Sources
- Benefits.gov | Social Security Medicare Program | Last accessed October 2023
- CMS | COBRA Continuation of Benefits | Last accessed October 2023
- CMS | Small Employer Exception | Last accessed October 2023
- Healthcare.gov | See 2022 Coverage Options | Last accessed October 2023
- SSA | Retirement Benefits | Last accessed October 2023