How Marriage and Divorce Affect Your Medicare Benefits

How Being Married Could Save You Money

Marriage Divorce and Medicare
Marriage can affect your Medicare benefits. coloroftime/E+/Getty Images

Unlike Medicaid, Medicare does not cover everyone in your family. Each individual has to meet Medicare eligibility criteria before the government will offer benefits. Those criteria include not only U.S. citizenship or legal residency but also proof of medical need. That medical need may be based on being 65 years of age or older or on your having a qualifying disability. This does not mean that your family life does not affect your Medicare benefits.

Underage Children Being Raised by Medicare Beneficiaries

In 2010, the Affordable Care Act (Obamacare) allowed young adults under the age of 26 to remain on their parents' health plans. The problem? This provision does not extend to Medicare. That can put many families on the hook for paying out of pocket for other sources of health care.

  • Disabled parents may need to provide health coverage for their children. They will need to access alternate insurance coverage and this is most often through Medicaid. Medicaid covers 8.8 million people with disabilities.
  • Challenges also arise for grandfamilies, families where children are raised by their grandparents. It is reported that 2.7 million grandparents are responsible for the needs of their grandchildren. Many of these grandparents will be older and on Medicare.

Health insurance marketplace or private insurance plans may be viable options to cover health care these children.

Defining Marriage According to Medicare

Prior to June 2013, marriage for the purposes of Medicare was defined as the legal union between a man and a woman. This was established by the 1996 Defense of Marriage Act (DOMA). When part of DOMA was repealed in 2013, the federal government offered Medicare benefits to same-sex married couples but only if they resided in states that recognized those marriages.

The U.S. Supreme Court has since struck down DOMA. As of June 2015, all marriages, same-sex or opposite-sex, are recognized for Medicare coverage no matter where they live in the country.

Qualifying for Medicare Savings by Marriage

There are several ways that marriage can save you money in Medicare. Each part of Medicare has its own rules. When you file taxes jointly, you may be put into a different income bracket that will change how much you are required to pay for your Part B or Part D premiums. Depending on your joint income, you may also be eligible for different Medicare savings programs. The income thresholds for these programs may be less for married couples than for single people.

The biggest benefit comes with Medicare Part A coverage. You can receive this hospital insurance for free, meaning that you will not pay a monthly premium, if you have worked 10 years (40 quarters) in Medicare eligible employment. Essentially, the government wants to know that you paid your fair share of taxes into the system.

It may be the case that you have not worked an adequate number of quarters to qualify you. However, you can be eligible for free Part A premiums on your spouse's record.

For this to happen, your spouse needs to be eligible for Social Security and have contributed 40 quarters in Medicare-taxed employment. You must also be married for at least one year before applying for free Part A benefits.

What Divorce Does to Your Medicare Costs

If you get divorced, you could still benefit from the work history of your former spouse under the following conditions:

  1. You were married for at least 10 years before you divorced.
  2. You remain single.

What Being Widowed Does to Your Medicare Costs

If you are widowed, you could be eligible for free Part A under the following conditions:

  1. You were married for at least nine months before your spouse passed away.
  2. You remain single.

What Happens to Your Medicare Costs When You Remarry

Remarrying after a divorce can have varying effects on your Medicare rights.

  • If you remarry and your former spouse is alive. Your former marriage will no longer be considered by Medicare when determining your Part A premium costs. 
  • If you remarry and your former spouse passes away. You will be eligible for free Part A on your former spouse's record if you remarried after age 60.
  • If you remarry and then divorce. Your Part A premiums may be based on the record on any of your former spouses as long as you remain single.

Sources:

Medicaid.gov. Individuals with disabilities. http://www.medicaid.gov/medicaid-chip-program-information/by-population/people-with-disabilities/individuals-with-disabilities.html. Accessed July 18, 2015.

Generations United. Grandfamilies. http://www.gu.org/OURWORK/Grandfamilies.aspx. Accessed July 18, 2015.

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