June 8, 2023 - 8:08 am
Dear Savvy Senior: My 63-year-old wife, who doesn’t work, is on my health insurance plan through my employer. When I retire next month and go on Medicare, what are our options for getting her health coverage until she turns 65? Is there some kind of Medicare coverage for dependent spouses? — Need Insurance
Dear Need Insurance: Unfortunately, Medicare does not provide family coverage to younger spouses or dependent children when you qualify for coverage. Nobody can obtain Medicare benefits before age 65, unless eligible at a younger age because of disability. Here are your best insurance coverage options your wife.
Affordable Care Act: In most cases, your best choice is to get your wife an individual health insurance policy through the Affordable Care Act health insurance marketplace. The marketplace offers comprehensive health coverage, and she won’t be denied coverage or charged extra for pre-existing health conditions.
And thanks to the American Rescue Plan and Inflation Reduction Act, the marketplace now provides enhanced subsidies through 2025. If your income falls below the 400 percent poverty level after you retire — anything below $73,240 for a couple or $54,360 for a single in 2023 — your wife will be eligible for a tax credit that will reduce the amount you will have to pay for her policy. The marketplace also ensures that households with incomes above that 400 percent poverty level will not have to pay more than 8.5 percent of their income for a benchmark policy.
To see how much subsidy you may be eligible for, use the Kaiser Family Foundation calculator at KFF.org/interactive/subsidy-calculator.
To shop for Marketplace plans in your state, visit HealthCare.gov or call 800-318-2596. Or, if you want extra help, contact a marketplace-certified agent or broker at HealthCare.gov/find-assistance.
COBRA: Another option is COBRA coverage, which would allow your wife to remain with your company insurance plan for at least 18 months after you make the switch to Medicare. But not every employer plan is COBRA-eligible. Contact your employer benefits administrator to find out if yours is.
You also need to be aware that COBRA is not cheap, requiring you to pay the full monthly premium yourself. But if you’ve already met or nearly met your employer plan’s deductible or out-of-pocket maximum for the year and don’t want your wife to start over with a new plan, it makes sense for your wife to keep her current coverage under COBRA.
Short-term health insurance: If you can’t find an affordable marketplace plan and COBRA is too expensive, the next option is short-term health insurance. These are cheaper, bare-bones health plans that provide coverage for one to 12 months and may be renewed for up to three years in some states. But be aware that short-term plans don’t comply with the Affordable Care Act, so they can deny sick people coverage, don’t cover pre-existing conditions and can exclude coverage essentials such as prescription drugs.
To find and compare short-term health plans, try sites such as eHealthInsurance.com or PivotHealth.com.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.