For people who meet the criteria to enroll in Original Medicare (those age 65 and older or with a qualifying disability), marital status will not affect eligibility to receive Original Medicare benefits. However, many people who are married rely on receiving healthcare benefits through their spouse, or vice versa. This can make navigating healthcare coverage complex if you become divorced or widowed. If you’re a beneficiary of Original Medicare, understanding its nuances and how they apply to the unique circumstances of divorce or losing a spouse is crucial to ensure that you maintain comprehensive healthcare coverage. From eligibility criteria and enrollment processes to potential implications for spousal benefits, you’ll want to review all the coverage options that apply to your particular situation.
When you’re going through a difficult situation like a divorce or the death of a spouse, one of the last things you want to be worrying about is whether or not you can keep your healthcare coverage. In this article, we’ll help you understand how being divorced or widowed may impact your Original Medicare coverage so you can feel confident about your options moving forward.
How does Original Medicare coverage differ for people who are divorced or widowed?
Eligibility for Original Medicare is primarily based on your work history, regardless of your former spouse's work history or current marital status. As a divorced individual, you may qualify for premium-free Medicare Part A based on your own work history, provided you meet the eligibility requirements. This is the part of Original Medicare that covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care services. Most people do not have to pay a premium for Medicare Part A because they or their spouse paid Medicare taxes while they were working. Here’s what you need to know about eligibility for premium-free Medicare Part A:
If you’ve worked over 10 years by age 65, you’ll likely get Part A coverage without paying a monthly premium. However, if you’ve been working less than 10 years (but more than zero) by age 65, you may qualify for a discounted Part A monthly premium.
If you already get retirement benefits from Social Security or the Railroad Retirement Board, you’re eligible to get Social Security or Railroad benefits but you haven’t filed for them yet, or you or your spouse had Medicare-covered government employment, you’ll likely qualify for premium-free Part A.
If you’re under age 65 and you received Social Security or Railroad Retirement Board disability benefits for 24 months, you have End-Stage Renal Disease (ESRD) and meet certain requirements, or if you have Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis or ALS) and meet certain requirements, you may qualify for premium-free Part A.
If you do not qualify for premium-free Medicare Part A, you’ll pay either $278 or $505 per month in 2024, depending on how long you or your spouse worked and paid Medicare taxes. Additionally, you may be eligible for Medicare Part B by paying the standard premium, which is $174.70 in 2024, if you do not meet the criteria for premium-free Part A. Medicare Part B helps cover medically necessary services like doctor's services, outpatient care, preventive services, and other medical services that Part A does not cover.
If you’re widowed, eligibility for Original Medicare is often linked to the work history of your deceased spouse. If you’re at least 65 years old and were married to your spouse for at least nine months, you’ll likely be eligible for premium-free Medicare Part A based on your deceased spouse's work history. You’ll still need to pay the standard premium for Medicare Part B. Keep in mind that you must sign up for Medicare Part B to buy Part A, and if you don’t buy Part A when you’re first eligible for Original Medicare, you might pay a penalty.
Are you eligible for Original Medicare before you’re 65 if you’re widowed?
As a widow or widower, you may be eligible for Original Medicare before the age of 65 based on your spouse's work history under certain conditions. If you’re widowed and were married to your spouse for at least nine months before their passing, you may qualify for premium-free Medicare Part A before turning 65 and can receive your social security benefits after turning 60. These benefits can start any time between age 60 and full retirement age for surviving spouses.
Additionally, if you are disabled and meet the following eligibility criteria, you may also qualify for Original Medicare before the age of 65:
You’ve been diagnosed with End-Stage Renal Disease (ESRD)
You’ve been diagnosed with Amyotrophic Lateral Sclerosis (ALS)
You’ve been receiving Social Security Disability Insurance for two years
People under the age of 65 who receive Social Security Disability Insurance (SSDI) payments generally become eligible for Original Medicare after a two-year waiting period, while those diagnosed with end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS) become eligible for Original Medicare with no waiting period.
It's important to note that there are specific rules and exceptions regarding eligibility for Original Medicare as a widow, and your individual situation may vary.
What are your Medicare Advantage plan options if you’re divorced or widowed?
If you're divorced or widowed, you may have various Medicare Advantage options available to you, providing opportunities for your healthcare coverage to meet your specific needs and circumstances. Medicare Advantage plans, also known as Medicare Part C, are legally required to provide the same coverage as Original Medicare but may include additional routine benefits. It’s helpful to understand your available Medicare Advantage plan options and how they align with your individual circumstances if you’re divorced or widowed and seek to make informed decisions about your healthcare coverage.
SelectQuote Can Help You Shop for a Medicare Advantage Plan If You’re Divorced or Widowed
If you’re divorced or widowed, you may feel overwhelmed by the process of selecting healthcare coverage that’s right for you, especially if you’re about to age into this type of health insurance. Fortunately, our licensed insurance agents are here to do the heavy lifting for you. If you’re interested in reviewing your Medicare Advantage plan options, we work with a variety of recognized insurance carriers so you can feel confident that you’ll find the right healthcare policy available in your area for your unique needs.
