What you need to know about your spouse’s Medicare coverage

Personal Finance


In addition, there is the risk that if you are covered by your spouse’s employer health plan and turn 65 that you can be kicked off the plan.

This is not common, Votava said, and would only happen if the employer has fewer than 20 employees. For companies with 20 employees or more, there are rules that prevent them from excluding someone who is Medicare eligible from coverage.

If you do stay on employer coverage through a small company, Medicare will often pay first before other health insurance coverage kicks in.

“A lot of people don’t realize that their employer coverage – once they’re 65 and in a smaller firm, 19 or fewer – doesn’t cover as much as they think it covers,” Votava said.

If you are in this situation, watch out that you do not get tripped up by these rules, Omdahl said.

Even if an employer with less than 20 employees allows you to stay on the plan, there are times when Medicare will be the primary payer. If you do not sign up for Medicare Parts A and B, that could become a problem, Omdahl said.

“Because there’s no primary payer, the group plan won’t pay, because it’s a secondary payer,” Omdahl said.

You would be able to sign up for Medicare right away, but your back medical expenses would not be covered, Omdahl said.



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