A Guide to Medicare Benefits for Spouses

If you’ve ever wondered, “Can my non-working spouse be on my Medicare plan?” — you’re not alone. Many couples ask this as they get closer to Medicare age.

Here’s the key: Medicare is individual coverage.

There’s no joint or family Medicare plan, even for married couples. But your spouse may still qualify for their own Medicare plan, especially if you’ve worked and paid Medicare taxes.

Medicare Eligibility for Non-Working Spouses

To get Medicare, your spouse must:

• Be 65 or older (or meet disability rules)
• Be a U.S. citizen or lawful permanent resident

If your spouse doesn’t have enough work history, they may still get Medicare based on your record, but they'll still need to enroll in their own plan. Work history doesn’t affect whether they qualify, just whether they pay for Part A.

Qualifying for Premium-Free Part A

Medicare Part A (hospital insurance) is usually free if you’ve worked and paid Medicare Taxes for 10 years (40 work credits).

That can help your spouse too:

• If you (the working spouse) have 40 work credits and are at least age 62, your spouse can get free Part A when they turn 65.
• If not, your spouse can still enroll, but they’ll pay a monthly premium for Part A until you meet the age and work requirements.

When One Spouse Becomes Eligible Before the Other

It’s common for one spouse to turn 65 before the other. When that happens, your options depend on who becomes eligible first.

If the Working Spouse Becomes Eligible First

The younger, non-working spouse may:

• Stay on the employer’s group health insurance (if offered)
• Use COBRA to continue health coverage for up to 18 months
• Shop for an individual plan on the Affordable Care Act (ACA) Marketplace

These options can help cover the younger spouse until they qualify for Medicare at 65.

If the Non-Working Spouse Becomes Eligible First

If the non-working spouse turns 65 but the working spouse is still employed:

• The older spouse can enroll in Medicare Part A (hospital insurance)
• They can delay Part B (medical insurance) without penalty, but only if they’re covered by a creditable employer plan

A creditable plan is one that offers coverage as good as Medicaid. If your employer plan isn’t creditable and you delay Part B, you may face a monthly penalty that lasts for life. Check with your employer or Medicare to confirm your plan qualifies. 

8 a.m.-8 p.m., 7 days a week.

Medicare When One Spouse is Older or Younger

If you and your spouse are different ages, signing up for Medicare can take some extra planning.

If the working spouse is younger, they must be at least 62 for the older, non-working spouse to get premium-free Part A based on their work history.

For example, if the working spouse is 60, the older spouse may qualify for Medicare but will likely have to pay a Part A premium until the younger spouse turns 62.

If the older spouse is non-working, they may be able to delay enrolling in Part B if they’re covered by the younger spouse’s employer plan. This can help save money, but the employer plan must count as creditable coverage (as good as Medicare). If it doesn’t, they could face late penalties later on.

When in doubt, talk to your employer’s benefits office or contact the Social Security Administration to confirm your timeline.

Types of Medicare Benefits Available to Spouses

If your spouse qualifies for Medicare (either through their own work records or yours) they’ll have access to the same coverage as any other eligible person. Medicare is divided into four main parts: A, B, C and D.

Here’s how each part works and how it may apply to your spouse:

Medicare Part A (Hospital Insurance)

Part A helps cover:

• Inpatient hospital stays
• Limited skilled nursing care
• Hospice care
• Some home health services

Your spouse can receive premium-free Part A if you’ve worked at least 10 years and paid Medicare taxes for at least 10 years (40 work credits) and you’re at least 62 years old.

If you don’t meet those requirements, your spouse can still enroll in Part A, but they’ll have to pay a monthly premium.

Medicare Part B (Medical Insurance)

Part B helps cover:

• Doctor visits
• Outpatient care and surgery
• Preventive screenings
• Durable medical equipment
• Mental health services

Part B always has a monthly premium. In 2025, the standard Part B premium is $185; with a $257 yearly deductible. After meeting the deductible, your spouse pays 20% of the Medicare-approved costs.

Even if they don’t go to the doctor often, it’s usually smart to enroll in Part B when first eligible. If they delay and don’t qualify for a Special Enrollment Period (SEP), they could owe late penalties for life.

Part C (Medicare Advantage)

Medicare Advantage (Part C) is an alternative to Original Medicare—not an add-on. These plans are run by private insurance companies.

They: 

• Replace Original Medicare (Parts A and B)
• Must cover at least the same services as Original Medicare
• Often include additional benefits, like dental, vision, hearing, transportation or wellness programs

To enroll in a Medicare Advantage plan, your spouse must already have both Part A and Part B. The same age, citizenship and work history rules apply.

A Medicare Advantage plan may be a good fit if your spouse wants bundled coverage and more predictable costs. Just remember plan costs and benefits vary by provider and location. 

Part D (Prescription Drug Coverage)

Part D helps cover:

• Prescription drugs
• Common medications for long-term conditions
• Flu shots and vaccines (in some cases)

Your spouse can get drug coverage by:

• Enrolling in a standalone Part D plan, or
• Choosing a Medicare Advantage plan with drug coverage (MAPD)

Premiums and covered drugs vary by plan, so it’s smart to review options each year, especially if your spouse takes regular medications.

Understanding Medicare Late Enrollment Penalties

Enrolling in Medicare late can lead to costly, lifelong penalties, so it’s important to sign up when you’re first eligible, unless you qualify for a Special Enrollment Period.

For Medicare Part B, the late enrollment penalty is an extra 10% added to your monthly premium for each full 12-month period you could have had Part B but didn’t enroll. This penalty lasts as long as you have Part B.

For Medicare Part D, the penalty is 1% of the national base beneficiary premium ($37.78 in 2025) for each month you went without creditable drug coverage after becoming eligible. The amount is added to your monthly Part D premium for as long as you have drug coverage.

The good news: If your spouse is covered under a creditable employer or union plan, they can delay Medicare enrollment without triggering these penalties. Always check with your benefits provider or Medicare to ensure coverage qualifies.

8 a.m.-8 p.m., 7 days a week.

Special Circumstances

Medicare rules can change for spouses after divorce, death or disability. In some cases, a spouse may still qualify based on the other’s work record.

Divorced Spouse

You may qualify if:

• The marriage lasted 10 years or more
• You’re 62 or older
• You’re currently unmarried

Widowed Spouses

You may qualify if:

• You were married at the time of death
• You meet SSA criteria for survivor benefits

Spouses of a Disabled Person

You may qualify if:

• You’re 62 or older
• You meet SSA rules for marriage length and work history

Applying for Spousal Medicare Benefits

If your spouse may qualify for Medicare based on your work record, here’s how to get started:

Step 1: Confirm Eligibility

Make sure your spouse is:

• Age 65 or older (or meets disability criteria)
• Meets marriage duration rules
• Can qualify through your work record (usually 40 credits or 10 years)

Step 2: Gather Documentation

You’ll need:

• Marriage certificate
• Birth certificate
• Proof of work history (like a Social Security Statement)

Step 3: Apply Through the SSA

• Apply online at gov/medicare
• Or visit a local Social Security office

Key Medicare Enrollment Periods

• Initial Enrollment Period (IEP): A 7-month window around your 65th birthday
• Medicare Advantage Open Enrollment Period (OEP): Jan 1 — Mar 31, for those already enrolled in MA to switch plans
• Medicare Annual Enrollment Period (AEP): Oct 1 – Dec 7, for those making changes to their coverage
• Special Enrollment Period (SEP): Available after loss of employer coverage or other qualifying events

Understanding Next Steps for Spousal Medicare Coverage

Medicare doesn’t offer family plans, but your spouse may still qualify for their own coverage, sometimes based on your work history.

Here’s what to remember:

• Medicare eligibility depends on age, marital status and work credits.
• Timing matters. Enrolling late or without the right coverage can lead to lifelong penalties.
• Medicare Advantage (Part C) is a full alternative to Original Medicare—not an add-on. Your spouse can choose either Original Medicare or Medicare Advantage, but not both.
• Talk to your employer’s benefits office or the Social Security Administration (SSA) to confirm your options.

Planning ahead now can help you avoid coverage gaps and feel confident about your next steps.

8 a.m.-8 p.m., 7 days a week.

Medicare Benefits for Spouse FAQs:

What kinds of extra benefits could my spouse get with a Medicare Advantage plan?

Medicare Advantage plans must cover everything Original Medicare does but may also include added perks. Depending on the plan, your spouse may get benefits like dental care, vision exams, hearing aids, fitness programs and even transportation or over-the-counter allowances.

Note: These extras vary by plan and location, so be sure to check with your provider to see what’s included.

Sources

• CMS.gov: 2025 Medicare Parts A & B Premiums and Deductibles
• Medicarefaq.com: Protect Yourself from Medicare Penalties: Key Tips and Deadlines
• Medicare.gov: What’s the Part D late enrollment penalty?
• Medicare.gov: Occupational therapy services
• Medicare.gov: Medicare Coverage of Therapy Services
• Medicareinteractive.org: Qualifying for premium-free Part A based on your spouse’s work history
• CMS.gov: 2025 Medicare Parts A & B Premiums and Deductibles
• CMS.gov: Original Medicare (Part A and B) Eligibility and Enrollment
• Medicare.gov: Costs
• Medicare.gov: 2025 Medicare costs
• Medicaremindset.com: How To: Enroll in Medicare on Your Spouse’s Work Record
• Medicare.gov: What does Medicare cost?
• Medicalnewstoday.com: Does Medicare cover people’s spouses?
• uhc.com: Medicare coverage for non-working spouses
• healthline.com: Understanding Medicare Work Credits

More About Medicare Coverage

• Does Medicare Cover Assisted Living?
• Does Medicare Cover Cataract Surgery?
• Does Medicare Cover Chiropractic Care?
• Does Medicare Cover Colonoscopy?
• Does Medicare Cover CPAP Machines?
• Does Medicare Cover Dentures?
• Does Medicare Cover Eye Exams?
• Does Medicare Cover Glasses?
• Does Medicare Cover Hearing Aids?
• 5 Things to Know About Medicare Hospice Benefits
• Does Medicare Cover Mental Health Services?
• Does Medicare Cover COVID-19 Tests?
• Does Medicare Cover Diabetic Supplies?
• Does Medicare Cover Blood Pressure Monitors?
• Does Medicare Cover Physical Therapy?
• Does Medicare Cover Palliative Care?
• Does Medicare Cover Weight Loss Drugs?
• How to Qualify for Home Health Care Under Medicare

Disclaimers