By Andrew L Hibbard
@WNYMrMedicare
Originally Posted: 08 MAY 2023
Updated & Revised:
For the aging Baby Boomers in Buffalo, Medicare eligibility has continued to be a common concern for the “stay-at-home” mom during the 1970’s and 1980’s.
Dad went to work. Mom stayed home. Dad made the money. Mom balanced the books. Dad paid FICA taxes, but Mom didn’t, and 40 years later, there’s conflicting and contrasting information around if Mom is eligible for Medicare.
Here’s what you need to know…
As long as one spouse, husband, or wife (or both) has been actively employed and paid FICA taxes from their paycheck for at least 40 quarters, or 10 years, then both the working and non-working spouse are eligible for Medicare.
To explain even further…
Because Medicare Health Insurance is individualized insurance, there is no spousal or family plan. So, when Medicare eligibility criteria is met, both the working spouse and non-working spouse are eligible for premium-free Medicare Part A Hospital benefits, and eligible for Medicare Part B Medical benefits, which each will pay their own, separate monthly premium.
What is often overlooked is the age difference between spouses. In many situations, the husband may be older than the wife.
If qualifying for Medicare eligibility by age, and not disability, 65 years old is the requirement.
Let me share with you Bob and Becky's story...
Bob the husband is nearing 65, and meets the 10 year work requirement, so he is eligible to sign up and start Medicare for the first day of his birth month in the year he turns 65.
However, his wife Becky, is only 63, and while she stayed at home with the kids and does not meet the 10 year work requirement, she is still eligible for Medicare under her husband Bob’s work and tax history, but not at 63…she has to wait until 65.
So, Bob and Becky can choose between a few choices:
CHOICE 1. Bob stops working and signs up for Medicare at 65, Becky being younger, would then need to buy an individual Obamacare medical plan through the New York State Exchange, under what I call the “un”Affordable Care Act.
CHOICE 2. Bob keeps working past 65, and keeps insurance through his Employer Group Health Plan, which allows younger wife Becky to remain insurance as a spouse on the same plan, therefore avoiding having to buy any costly Obamacare coverage.
Either way, when Becky at the age of 65, she will be eligible to sign up for Medicare because husband Bob meets the Medicare eligibility requirements.
Bob would sign up and start Medicare at the same time as Becky. Becky at 65. Bob at 67.
When Bob signs up later in life, he would be assessed a costly late enrollment penalty --- which is an added fee to the Medicare monthly premium, which you pay month after month, for life.
Bob can get his late enrollment penalty waived is he can submit an additional form, signed by his benefits administrator proving he had “credible coverage” from active employment, insured by an Employer Group Health Plan, with 20 or more employees insured on the same plan.
The bottom line is this…
Can A Non-Working Spouse Get Medicare Living In WNY?
Getting a non-working spouse Medicare coverage can be done.
There are some minor hassles and hoops to jump through, but not impossible.
If there is an age difference between spouses, and the older spouse will work past 65 to provided continued health insurance until the younger spouse is 65 and eligible for Medicare, there will major, not minor, hassles and hoops to jump through. (Think guilty until you prove your innocence).
Ok, there’s a lot to deal with, right? I get it.
And as an active adult in WNY, who’s always on the run, you need a smart solution to cut through all the clutter.
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NEARING AGE 65 AND AREN'T SURE WHERE TO START?
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ABOUT THE AUTHOR
Andrew L Hibbard is a prominent name when mentioning Medicare in WNY, but one you may have never heard of. Working behind-the-scenes, he is a best-selling author, expert advisor and successful agency owner. Focused on educating first, Andrew prides himself on being considered “the only advocate in WNY fighting for better and more reliable Medicare resources, free from insurance company conflict of interests.”
To take away the stress of trying to tackle Medicare alone and feeling forced to figure it all out by yourself --- Andrew created the WNY Medicare SmartStart Program; a free, step-by-step plan, that holds you by the hand to sign up and start Medicare smartly. (More than 850+ people have gone through the program and call it “the lazy way to get Medicare done for you without costing you a dime”).
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