Non working spouse Medicare

[FIRE man]

I was hoping someone here might be able to answer a question for me as calling and talking to the people at Medicare has not resulted in an answer.

My wife is turning 65 in July. I will only be 60 at the time and will not be 62 for 15 months after she turns 65. My wife does not have credits and will need to use my credits for Medicare but can not use my credits until I turn 65.

We currently get our medical coverage under the ACA Marketplace.

My question is does my wife have to get Medicare at 65 even though she doesn't qualify for free part A until I turn 62? If she waits until she is eligible for free Part A will she be subjected to the penalty? Could she stay on the ACA until I turn 62 and qualifies for free Part A?

Any help is appreciated

Richard and Mary

 

[lrip]

My experience was as that my non-working wife had to sign up for Medicare on time. She is older than me. I am still under our previous insurance and it is now her secondary insurance. Kind of stinks because Medicare costs more than our previous insurance for her.

 

[MichaelB]

I was hoping someone here might be able to answer a question for me as calling and talking to the people at Medicare has not resulted in an answer.

My wife is turning 65 in July. I will only be 60 at the time and will not be 62 for 15 months after she turns 65. My wife does not have credits and will need to use my credits for Medicare but can not use my credits until I turn 65.

We currently get our medical coverage under the ACA Marketplace.

My question is does my wife have to get Medicare at 65 even though she doesn't qualify for free part A until I turn 62? If she waits until she is eligible for free Part A will she be subjected to the penalty? Could she stay on the ACA until I turn 62 and qualifies for free Part A?

Any help is appreciated

Richard and Mary

Your eligibility for Social Security determines your eligibility for Medicare. If you worked and paid into Social Security for 10 years, you are eligible.

If you are eligible for Social Security your spouse is automatically eligible for SS. Therefore, your spouse is eligible for Medicare. That’s it.

She qualifies for Medicare when she turns 65 regardless of your age. Neither of you need to file for SS. She can enroll by visiting a SS office, over the phone, and may be able to apply online.

 

[FIRE man]

She is not eligible for Medicare under my points until I turn 62 and she does not have enough points on her own to qualify. She is eligible for Medicare at 65 but it will not be qualify for premium-free Part A and will cost ~$500.00 per month until she qualifies under my points 15 months later. I was wondering if she could delay her enrollment until she qualifies under my points and not pay the late enrollment penalty.

 

[FIRE man]

I got it from the Medicare site.

Part A is free if you or your spouse has worked and paid taxes to Medicare for at least 40
quarters (10 years). If you do not have enough working quarters, you will have to pay a
premium for Part A. Part B always has monthly premium. If you have a Medigap or Part D
plan you may have pay a monthly premium for these as well. Keep in mind that Medicare
Advantage (MA) plans have different costs than Original Medicare. If you have a low income,
you may qualify for programs that can help pay your Medicare premiums and other costs.

Like I said my wife has not contributed for 40 quarters and will only qualify for premium-free part a when I reach 62

 

[FIRE man]

Looks like we can keep her on our ACA plan until she qualifies for premium-free part a, but it doesn't discuss the penalty.

However, you can purchase a plan in the exchange in lieu of Medicare if you would otherwise be required to pay premiums for Medicare Part A due to a work history that’s insufficient to qualify for premium-free Part A benefits. And if you’re already enrolled in a plan through the exchange and would have to pay a premium for Medicare Part A, you can opt instead to continue to receive a premium subsidy in the exchange, assuming you continue to meet the subsidy eligibility requirements.

 

[pacergal]

OP--If you have worked and paid medicare taxes for ten years (40 quarters), then I believe both you and your wife would qualify for medicare when you each reach 65.

Also, I understand that if you do not sign up, there are permanent penalties for your Plan B (providing you do not meet the exceptions).
If you did not get your questions answered to your satisfaction, I would try calling again to both Medicare and possibly Social Security.

edit--correction: I believe you must be 62 for your wife to qualify, so perhaps she will need to get ACA at 65, until you turn 62 (?)
Again, calling directly to medicare again would be your best bet

 

[FIRE man]

Yes I'm aware of that, that's why I stated she doesn't have enough credits on her own, she is a non working spouse and will have to wait until I'm 62 to be eligible under my credits. This is kind of a special situation and I was hoping someone with an in-depth understanding of Medicare rules might be lurking about here somewhere.

 

[FIRE man]

I called the Social Security office, they couldn't answer the question, told me to call Medicare, I spoke to three different people in Medicare office and the last supervisor told me to call the Social Security office back and ask for a supervisor there. I did that but that just started the loop over again

 

[ShokWaveRider]

Lots of conflicting opinions posted here. Not sure where they got their info, whether correct or otherwise.

Here is something I found that may help you.

Unless YOU have NOT earned 40 payments, then your spouse is eligible. It is not clear if you have or whether you WILL have by the time you reach 62.

https://www.aarpmedicareplans.com/medicare-articles/medicare-coverage-for-non-working-spouses.html


"Can Your Non-Working Spouse Get Premium-Free Medicare Part A?


Yes! If YOU worked and paid Medicare taxes through payroll deductions for at least 10 years, then you and your spouse will both for premium-free Medicare Part A at age 65. There’s no premium for it because your Medicare tax dollars go into the hospital insurance trust fund, which then finances Medicare Part A benefits for eligible individuals."

 

[fosterscik]

Lots of conflicting opinions posted here. Not sure where they got their info, whether correct or otherwise.

Here is something I found that may help you.

Unless YOU have NOT earned 40 payments, then your spouse is eligible. It is not clear if you have or whether you WILL have by the time you reach 62.

https://www.aarpmedicareplans.com/medicare-articles/medicare-coverage-for-non-working-spouses.html


"Can Your Non-Working Spouse Get Premium-Free Medicare Part A?


Yes! If YOU worked and paid Medicare taxes through payroll deductions for at least 10 years, then you and your spouse will both for premium-free Medicare Part A at age 65. There’s no premium for it because your Medicare tax dollars go into the hospital insurance trust fund, which then finances Medicare Part A benefits for eligible individuals."

BUT further down in the same article:

It’s important to note that your age, as the working spouse, will affect when your non-working spouse qualifies for premium-free Medicare Part A. You must be at least 62 years old and eligible for Social Security benefits before your spouse can enroll, because his or her qualification is based on your work record. You don’t have to actually start getting your Social Security benefits; you just need to be old enough to file for them if you wanted to. If you are younger than 62, your spouse may choose to pay the premium for Medicare Part A, if needed, until the premium-free benefit kicks in.

 

[FIRE man]

Yes I understand my wife will qualify for premium free Medicare under my points when I turn 62, she has not contributed to qualify herself.

I did just read that she can stay on our ACA plan and we still receive subsidies since she doesn't qualify for premium free Medicare. So that looks like our best option, my only question now would be the penalty and if it applies in this situation.

 

[ShokWaveRider]

BUT further down in the same article:

Thanks for that I did not read that far. Then that is the answer there.

Until then she will have to use the ACA. I would call them. If I remember one of the questions of the ACA requirements is are you eligible for healthcare somewhere else? I would need to check if it get terminated at 65. I find it hard to believe as the ACA was designed to cover as many folks as possible, under given situations.

Here is another article.

https://obamacarefacts.com/questions/over-65-and-dont-qualify-for-medicare-can-i-get-obamacare/

"ere is How ObamaCare Works if You are Over 65, But Don't Qualify For Medicare
You’re over 65 but not eligible for Medicare. You are eligible to get coverage on HealthCare.gov (the ObamaCare marketplace). If you meet the qualifications based on income and family size, you are eligible for cost-saving subsidies, too."

 

[FIRE man]

Yes that's what i read too, We can keep her on the ACA and still get the subsidies since she doesn't qualify for premium-free Medicare Part A. I think we still need to sign her up for Part B since it is not premium free insurance. I still don't know if there will be a penalty for delaying the Part A signup thogh

 

[ShokWaveRider]

Yes that's what i read too, We can keep her on the ACA and still get the subsidies since she doesn't qualify for premium-free Medicare Part A. I think we still need to sign her up for Part B since it is not premium free insurance. I still don't know if there will be a penalty for delaying the Part A signup thogh

Not exactly sure, but I highly doubt it. If she is not eligible how can she be penalized? Then after she becomes eligible for Medicare, she becomes Un-eligible for the ACA.

 

[FIRE man]

She is eligible for Medicare Part A, just not premium-free, she could sign up and pay ~$500.00 per month premium until eligible for premium-free under my credits (about 15 months) also if we delay she can only sign up during the special enrolment or general enrolment periods

 

[ivinsfan]

Yes that's what i read too, We can keep her on the ACA and still get the subsidies since she doesn't qualify for premium-free Medicare Part A. I think we still need to sign her up for Part B since it is not premium free insurance. I still don't know if there will be a penalty for delaying the Part A signup thogh

It's the word "qualifies" that's the problem, it doesn't say your has to get free Part A if she qualifies but has to pay that's different then saying not qualifying.

 

[ivinsfan]

She is eligible for Medicare Part A, just not premium-free, she could sign up and pay ~$500.00 per month premium until eligible for premium-free under my credits (about 15 months) also if we delay she can only sign up during the special enrolment or general enrolment periods

This is the sticky problem with keeping ACA if you qualify you qualify if you choose not to use it because it isn't free yet that's different.

 

[ivinsfan]

Not exactly sure, but I highly doubt it. If she is not eligible how can she be penalized? Then after she becomes eligible for Medicare, she becomes Un-eligible for the ACA.

OP is saying she is eligible but won't get Part A for free that's not the same as not being eligible.

 

[FIRE man]

Part A: If you qualify for premium-free Part A, you should enroll in Part A when
you turn 65. However, if you have to pay a premium for Part A, you can delay
Part A until you (or your spouse) stop working or lose that employer coverage.
You will NOT pay a penalty for delaying Part A, as long as you enroll within
8 months of losing your coverage or stopping work (whichever happens first)

So looks like no penalty if we delay the Part A, the best option seems to just sign up for Part B at 65 then wait until she qualifies under my points for premium-free Part A and there will not be a penalty

"If you lack the work history required to be eligible for premium-free Part A, you may not want to pay for hospital insurance because of its high monthly premium. While it is always advisable to have Part A, you can buy Medicare Part B (medical insurance) without having to buy Medicare Part A (hospital insurance) as long as you are:

Age 65+
And, a U.S. citizen or a legal resident who has lived in the U.S. for at least five years

 

[ivinsfan]

Yes that's what i read too, We can keep her on the ACA and still get the subsidies since she doesn't qualify for premium-free Medicare Part A. I think we still need to sign her up for Part B since it is not premium free insurance. I still don't know if there will be a penalty for delaying the Part A signup thogh

Did you have a source for this, I though the marketplace rules were pretty clear that if have access to Medicare you can't get subsidies.


There are definitely a few posters here that had their insurance costs go UP after getting on Medicare...but it's not optional.



I don't know how big your subsidy is but rather then lose it you might just need to suck it up and pay for her part A..

 

[FIRE man]

Age: Nothing but a number
There’s no upper age limit for subsidy eligibility. But most people become eligible for premium-free Medicare Part A when they turn 65. In that case, they lose their eligibility for premium subsidies.

But if you’re not eligible for premium-free Medicare Part A because you don’t have enough work history in the U.S., you can continue to buy coverage in the exchange, and you’ll continue to receive premium subsidies if your income makes you eligible. (See question A6 in this guide from CMS.)

 

[FIRE man]

https://www.cms.gov/Medicare/Eligib...edicare-Marketplace_Master_FAQ_8-28-14_v2.pdf

 

[ivinsfan]

Age: Nothing but a number
There’s no upper age limit for subsidy eligibility. But most people become eligible for premium-free Medicare Part A when they turn 65. In that case, they lose their eligibility for premium subsidies.

But if you’re not eligible for premium-free Medicare Part A because you don’t have enough work history in the U.S., you can continue to buy coverage in the exchange, and you’ll continue to receive premium subsidies if your income makes you eligible. (See question A6 in this guide from CMS.)

Page 5 does say that penalties may be invoked when you do this...If I understand the process correctly those penalties are lifetime.


Confusing for sure.

 

[FIRE man]

Penalties for Part A are not for lifetime, but I believe Part B are lifetime, that is why I would really want to understand this before making the decision to delay. Seems like there should be someone in the bureaucracy that would be fluent in these matters and advise us of what is best