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Important Things to Know About Medicare Coverage of Your Spouse

Healthcare continues to remain an important issue in America and at the center of many election campaigns over the years. Compared to welfare states around the world, the US does not fare well as far as effective healthcare coverage of its citizens is concerned.

Hence, it’s completely natural for you to worry about whether your spouse is covered under the Medicare coverage plan which he or she may be eligible for based upon the work record which you have built up over the years, and unfortunately things are not crystal clear. No matter, we have some guidance for you to figure it out.

Your spouse may be eligible for Medicare coverage, and like majority of Americans, you just don’t know it

Many Americans Are Unaware

According to research conducted by MassMutual, which included Americans between the ages of 60 and 64, the majority of Americans in this age cohort have incorrect information about whether their spouse is eligible for coverage or not.

The statement which revealed this shocking fact was a true and false one, and it stated whether one is eligible for receiving Medicare benefits if the spouse was eligible, considering one is ineligible. Only 21% of the respondents to this true and false statement could answer in the affirmative, which was the correct answer, while the rest answered in the negative, which is incorrect.

According to a survey, only 21% of Americans between 60 to 64 know about Medicare coverage eligibility for their spouse

Age Is A Factor

There isn’t a very big set of criteria which your spouse needs to satisfy to qualify for coverage. The only thing which is required is age. Simply put, if your spouse has reached or crossed the age of 65, or is medically disabled, he or she qualifies for Medicare coverage being the spouse of an eligible member.
For a person to become eligible, he or she needs to have made contributions to the system of Social Security. You must already be aware that there are certain benefits which come with Social Security in the US, and Medicare coverage comes under those as well.

Even if you are entering a divorce or have divorced already, under certain conditions stipulated by Social Security Administration, your spouse or ex-spouse may still be eligible for benefits under this clause.

Of course, matters become a bit more technical in cases where the spouse is not even close to attaining the age of eligibility, until which time it may be difficult to secure sufficient Medicare coverage. Another issue arises when you are not eligible for Medicare coverage yourself, in which case you would have to secure coverage through other means, usually through private insurance companies, which can be a costly endeavor.

Employer Plans May Not Be Helpful

Companies which have more than 20 employees are barred from excluding anyone from their health plan who is otherwise eligible for health coverage after turning 65 years of age. Unfortunately, for those companies which have less than 20 employees working under their payroll, there are no such rules, and even when you turn 65 and eligible for Medicare coverage, they can choose to exclude you, the spouse, from coverage.
However, that is not a major cause of concern. In the case of less than 20 employees, such a company would not be paying more than what you would be eligible for under Medicare coverage. But, for this to happen, you need to be a signatory to both the Plans, A and B, of Medicare.

An Account For Health Savings

That account which allows you to save your pre-tax income for healthcare ceases to remain legal as soon as you sign up with Medicare, although it is completely legal before that happens even with a healthcare coverage plan.

This applies to both yourself and your spouse, so even if only you reach the age of 65 and sign up for Medicare, while your spouse is still well under 65, both of you will still lose the right to maintain such an account.

However, there is an exception to that rule when you maintain such an account with your employer and only your spouse signs up for Medicare coverage. In such a scenario, you can continue to make contributions to this account, as that is allowed under law.

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