I’m 65 and Ready for Medicare but My Spouse is Not, What Now?

by | Jun 30, 2022

One question that we at Acuity Health Advisors get on a pretty regular basis is this:

What happens when one spouse is retiring and going on Medicare but the other spouse is not yet 65 and will be losing their employer coverage?

You have two options of coverage for the spouse that is not ready to enroll in Medicare.

Head To The Marketplace

The first option is for that spouse to go to Healthcare.gov and find a Marketplace plan. This will be an Affordable Care Act compliant plan. Some of the advantage of this type of plan include:

  • 100% coverage for preventative care
  • Pre-existing conditions will be covered
  • These plans also allow you to qualify for a tax credit to help lower the cost of these plans
  • Tax credit qualification will be dependent on your income

Some disadvantages include

  • Possibly high deductibles and maximum out of pocket costs
  • You can only enroll during annual Open Enrollment or with a qualifying event (losing coverage would qualify)

Find A Private Plan

The second choice is going to be a private plan. There are several different companies that offer private plans. These types of plans will usually be underwritten, which means there will be health questions asked at application. There is the possibility that you can be denied acceptance into these plans, depending on your health history. If you have any serious health conditions, it can be very difficult to qualify. That means your only option will be to choose an Affordable Care Act plan.

If you are in this situation and you need some guidance, we’d be happy to help. We can help you decide which path is best for you and help you enroll. Give us a call anytime and we will do our best to answer any and all of your questions. Our services are always no cost to the client. We would love to hear from you!