Can My Spouse Under the Age of 65 Receive Medicare Coverage?

If your spouse is under age 65, Medicare will not cover them unless they qualify for Medicare on their own. If you are a Medicare beneficiary, your coverage does not extend to your spouse.

The only way to collect Medicare benefits before age 65 is by having a qualified disability or medical condition. You can only earn Medicare eligibility based on your own disability, not because your spouse is eligible for Medicare.

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How can my spouse get Medicare before age 65?

If your spouse is under age 65, they could potentially qualify for Medicare if one of the following circumstances applies to them:

  1. If they have ALS (amyotrophic lateral sclerosis, or Lou Gehrig’s disease), they will qualify for Medicare as soon as they begin receiving disability benefits.

  2. If they receive Social Security Disability Insurance (SSDI) benefits or certain Railroad Retirement Board (RRB) disability benefits for at least 24 months, they may be automatically enrolled in Medicare beginning in the 25th month of receiving their disability benefits.  

  3. If they have End-Stage Renal Disease (ESRD, kidney failure that requires dialysis and/or a kidney transplant), they may be eligible for Medicare benefits shortly after beginning dialysis treatments or having a kidney transplant. They (or you, their spouse) must also meet the requirements for SSDI benefits.

Your younger spouse can affect your Medicare coverage at age 62

If you qualify for Medicare but did not pay Medicare taxes for at least 40 quarters (10 years), you will not be eligible for premium-free Medicare Part A (hospital insurance). You will have to pay a monthly Part A premium, which can be as high as $437 per month in 2019.

When your younger spouse reaches age 62, you may be able to get premium-free Part A coverage if your spouse has paid the required amount of Medicare taxes (40 quarters), regardless of whether or not you paid any Medicare taxes.

Note: You must be married for at least one year before an older spouse can be eligible for Medicare based on a younger spouse’s work record.

Can my spouse get Medicare Advantage under age 65?

If you have a Medicare Advantage plan (Medicare Part C), it does not cover your spouse. If your spouse is under age 65, they will only be eligible for Medicare Advantage plan coverage if they are eligible for Medicare, as outlined above.

  • Generally speaking, most people who are enrolled in or are eligible for Original Medicare (Medicare Part A and Part B) are also eligible for a Medicare Advantage

  • The one exception is for someone with ESRD, as most Medicare Advantage plans are not available for people who have ESRD. In such a case, a Medicare Advantage Special Needs Plan may still be an option.

A Medicare Advantage plan can offer additional benefits not covered by Original Medicare. Some of these additional benefits may include:

Some Medicare Advantage plans may also cover home care items or services, such as bathroom grab bars or meal delivery.

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Does Medicare Part D cover my spouse under 65?

Medicare Part D, which provides coverage for prescription drugs, may be obtained by anyone under the age of 65 who qualifies for Original Medicare because of a disability or condition, as outlined above.

If you have Medicare Part D coverage, your plan does not cover your spouse. They must qualify for a Part D plan on their own.

Does Medicare Supplement Insurance cover my spouse under 65?

Medicare Supplement Insurance, or Medigap, can be used in conjunction with Original Medicare coverage to help pay for some Medicare out-of-pocket costs such as deductibles and copays. If you have a Medigap plan, it does not cover your spouse.

Depending on your Medigap plan provider, you could potentially get a discount if you and your spouse enroll in separate individual policies from the same insurance company.

In the following states, insurance companies are required to offer at least one Medicare Supplement Insurance plan to people under the age of 65 with a disability who qualify for Original Medicare:

  • California (excluding those with ESRD)
  • Colorado
  • Connecticut
  • Delaware (only for those with ESRD)
  • Florida
  • Georgia
  • Hawaii
  • Illinois
  • Kansas
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts (only for those with ESRD)
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • New Hampshire
  • New Jersey
  • New York
  • North Carolina
  • Oklahoma
  • Oregon
  • Pennsylvania
  • South Dakota
  • Tennessee
  • Texas
  • Vermont (excluding those with ESRD)
  • Wisconsin

The federal government does not require all states to offer Medigap plans to anyone under 65, even if those individuals qualify for Original Medicare because of a disability. In addition, the cost of a Medigap plan for someone under 65 may be higher.

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Are you or your spouse nearing Medicare eligibility? Are you already eligible for Medicare?

You may be able to enroll in a Medicare Advantage plan that offers the benefits you need. Some $0 premium Medicare Advantage plans may be available in your area, though $0 premium plans are not offered in all locations.

To learn more about your Medicare Advantage plan options, speak with a licensed insurance agent by calling TTY Users: 711 24 hours a day, 7 days a week.

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MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.