To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.
Navigating Medicare can be complex, especially when you're considering how it works for both you and your spouse. Understanding the ins and outs of Medicare as a married couple can help you maximize your benefits and avoid potential pitfalls. Whether you're new to Medicare or have been enrolled for years, it’s important to understand how marriage affects your Medicare options and coverage.
Individual Plans, Shared Benefits
One of the first things to know is that Medicare is an individual program. This means that each person must sign up separately, and your benefits are not automatically shared with your spouse. However, being married can influence your Medicare choices and costs in a few important ways.
For example, if your spouse has not worked the required 40 quarters (10 years) needed to qualify for premium-free Medicare Part A (hospital insurance), they may still be eligible through your work record. This can save you a significant amount of money, as the standard premium for Part A in 2024 can be up to $560 per month. More details on Medicare costs in 2024 are available on Medicare.gov.
Additionally, if you or your spouse are still working and have health insurance through an employer, you may be able to delay enrolling in Medicare Part B (medical insurance) without facing late enrollment penalties. This can be particularly beneficial if your employer’s plan offers better coverage or lower costs than Medicare.
Timing Matters
Enrollment timing is crucial for married couples. If one or both of you are approaching age 65, you should start thinking about Medicare enrollment. The Initial Enrollment Period (IEP) starts three months before you turn 65, includes the month you turn 65, and ends three months after your birthday month. Missing this window can result in late enrollment penalties that last for as long as you have Medicare.
For those already receiving Social Security benefits, enrollment in Medicare Parts A and B is automatic. However, if you’re delaying Social Security until after 65, you’ll need to actively sign up for Medicare during your IEP.
If both you and your spouse are enrolling at the same time, coordinating your enrollment periods can help ensure you both get the coverage you need without any gaps.
Spousal Coordination of Medicare Advantage and Medigap Plans
When it comes to Medicare Advantage (Part C) or Medigap (Medicare Supplement Insurance) plans, coordination is key. These plans are sold by private insurance companies and can offer additional benefits beyond what Original Medicare (Parts A and B) provides.
However, Medicare Advantage and Medigap plans are also individual plans. Each spouse will need to enroll separately, and each plan may have different premiums, networks, and coverage options. It’s a good idea to compare plans together to see which options work best for your specific needs and budget.
Some couples find that enrolling in the same Medicare Advantage plan can make it easier to manage their healthcare. This can be especially true if you and your spouse see the same doctors or use the same healthcare facilities. More information on Medigap costs can be found on Medicare’s website.
To help you navigate these options and find the best plan for your needs, we’ve teamed up with Chapter to provide personalized, 1-1 guidance.
Consider Income-Related Adjustments
Your combined income as a married couple can affect your Medicare costs. For example, if your Modified Adjusted Gross Income (MAGI) as a couple exceeds certain thresholds, you may have to pay more for your Medicare Part B and Part D (prescription drug coverage) premiums. This surcharge is known as the Income-Related Monthly Adjustment Amount (IRMAA).
In 2024, if your joint income is above $206,000, you’ll pay more for Parts B and D. Understanding how your income affects these costs can help you plan better and possibly take steps to minimize your premiums. Find more details on Medicare’s cost structure in the 2024 Medicare fact sheet.
Navigating Medicare as a Team
Medicare for married couples involves careful planning and coordination. By understanding how Medicare works individually and as a couple, you can make informed decisions that benefit both you and your spouse. Don’t forget to review your coverage annually during the Medicare Open Enrollment Period (October 15 to December 7) to ensure it continues to meet your needs.
To learn more about how Medicare can work for you and your spouse, consider joining a Medicare class on GetSetUp. These classes are designed to help you navigate the complexities of Medicare with confidence.