Health Coverage Options for Pre-Medicare-Age Spouses

Medicare does not offer coverage for younger spouses or dependent children when the other spouse qualifies for Medicare. No one may receive Medicare benefits prior to the age of 65, unless eligible at a younger age due to a disability. What can be done to cover the younger spouse?

There are some options that may be considered for the younger spouse who is not ready to retire. Those options include planning on working past the retirement age of 65, if that is at all possible, which would permit the younger spouse to continue to be covered under an employer health insurance plan until they are eligible for Medicare.

Failing that option as a possibility, there may be employer options open, such as the employer providing retiree health benefits. This is something that would need to be checked with the benefits administrator along with asking whether or not your spouse may continue under their plan as well. In addition, if your spouse is employed, they may switch to their employer’s provided health care plan.

Individual health insurance through the Health Insurance Marketplace, or Obamacare, may be worth considering as well, especially since the proposed health care plan by the current White House administration did not pass, keeping the health care plan in place. Thus, insurance pricing is currently very competitive. The policies offer comprehensive health coverage, insurers cannot deny coverage or charge extra for pre-existing conditions.

An option to consider is COBRA. If you work for a firm that has 20 or more workers, once you make the change to Medicare, your younger spouse could stay with the company insurance for 18 to 36 months. While this is an expensive option, it may work for you depending on your circumstances. If the company has fewer than 20 workers, continued coverage may be available provided your particular state has what is referred to as “mini-COBRA.”

If your income is below the 400 percent poverty level ($64,080 for couples, $27,520 for individuals) then you may be able to receive a tax credit to reduce the amount you will have to pay for a health insurance policy.

For information on insurance plans in your state visit https://www.healthcare.gov/ or call the toll-free helpline at 800-318-2596.