Medicare Essentials for Stay-at-Home Spouses

Medicare Essentials for Stay-at-Home Spouses

September 21, 2023

Typically, individuals aged 65 and above are eligible to enroll in Medicare. However, to qualify for premium-free Medicare Part A, both men and women must have worked and paid taxes for at least 10 years, earning 40 credits in total.

Some women may not have worked long enough to earn the required 40 credits on their own. In such cases, marital status becomes significant. A woman (or man) may be able to qualify based on the work history of a spouse who is 62 years or older and has earned the necessary 40 credits. Specific requirements apply to each situation:

  • If married for at least one year: You may qualify based on your current spouse's employment record.
  • If divorced: You may be eligible if your previous marriage lasted at least 10 years, and you are currently single.
  • If widowed: You must have been married for at least nine months and currently be single.

It is important not to delay the enrollment process.

If a woman doesn't qualify for premium-free Part A, she can purchase it and must also enroll in and pay for Part B. This should be done when first eligible at age 65, as there may be a penalty for late enrollment. After enrolling in Parts A and B, she can choose additional Medicare coverage options, including Medicare supplement insurance plans (also known as Medigap), Part D prescription drug plans, or Medicare Advantage plans.

It's worth noting that Medicare eligibility cannot be based on the work history of a domestic partner. The eligibility of civil unions depends on the state, and currently, fewer states recognize them. For more information on civil union eligibility, it is advisable to consult the state insurance commissioner or relevant authorities.

When a spouse retires at 65, women who have been insured under their older spouse's plan face the dilemma of finding new healthcare coverage. Several factors should be considered, such as the woman's age, the time until she turns 65, her health status, and the available options.

One option to consider is COBRA continuation coverage. If the working spouse is enrolling in Medicare, spouses can qualify for up to 36 months of COBRA coverage. However, COBRA can be expensive as the individual is responsible for the entire premium. The affordability of COBRA may depend on the woman's age and health status. It is essential to carefully evaluate the costs and benefits of COBRA coverage based on personal circumstances.

Another option to explore is the Healthcare Insurance Marketplace.

The Affordable Care Act has eliminated pre-existing conditions as a barrier for new enrollees in the individual market and some other situations. This means that pre-existing conditions would not impact coverage options if a person decides to continue with COBRA. Considering the Healthcare Insurance Marketplace may provide more cost-effective alternatives to COBRA.

When shopping for a plan in the marketplace, it is advisable to check the state's website for relevant information and resources. Start investigating and exploring options as soon as it becomes evident that new coverage will be necessary. Taking a proactive approach allows for sufficient time to evaluate different plans, understand their benefits and costs, and make an informed decision that aligns with specific needs and circumstances.

To ensure a smooth transition to Medicare, regardless of their work history, individuals should focus on key considerations. Here are specific steps to prepare for:

  1. Establish or update financial and medical powers of attorney. These legal documents grant authority to trusted individuals who can make healthcare and financial decisions on your behalf. Review and update these documents as necessary to ensure they accurately reflect your wishes.

  2. Create a My Social Security account. Setting up an account allows you to access and manage your Social Security information online. Take the time to create an account and verify that your personal details are current and accurate.

  3. Confirm your eligibility for Medicare. Visit the official Medicare website ( to understand if you meet the requirements and if you are eligible for premium-free Part A or need to pay for it.

  4. Determine your Initial Enrollment Period. This is a specific timeframe during which you can enroll in Medicare without incurring penalties. It is important to know when this period occurs for you so that you can make informed decisions about your Medicare coverage. Missing the enrollment deadline may result in higher premiums, so it is crucial to stay aware of this timeframe.

If you have questions please let us know.

Flagship Financial Advisors is excited to announce our partnership with Healthpilot to bring you a White Glove Medicare shopping experience at no cost to you!

Investment advice offered through Stratos Wealth Advisors, LLC, a Registered Investment Advisor. Stratos Wealth Advisors, LLC and Flagship Financial Advisors are separate entities. Please remember that past performance is no guarantee of future results. Different types of investments involve varying degrees of risk, and there can be no assurance that the future performance of any specific investment, investment strategy, or product (including the investments and/or investment strategies recommended or undertaken by Flagship Financial Advisors, or any non-investment related content, made reference to directly or indirectly in this commentary will be profitable, equal any corresponding indicated historical performance level(s), be suitable for your portfolio or individual situation, or prove successful. Due to various factors, including changing market conditions and/or applicable laws, the content may no longer be reflective of current opinions or positions. Moreover, you should not assume that any discussion or information contained in this commentary serves as the receipt of, or as a substitute for, personalized investment advice from Flagship Financial Advisors.