Spousal Medicare Advice

Jun 3, 2016

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  1. melmadhav
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    melmadhav Expert

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    Need reassurance before I advise...I have a client that is 59, wife is T-65, she has never paid in to Medicare. In researching she is not eligible to get spousal Medicare until the husband is 62. Is this correct?

    Thanks in advance!
     
  2. TN_agent
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    https://www.medicare.gov/sign-up-ch...ditions/special-conditions.html#collapse-3163

    That is my understanding based on the link above. It is interesting that they still advise to enroll in part B. (in a good way)

    But if the income fits, she can get ACA subsidy if otherwise eligible (no work coverage offered, etc) since there is not a premium-free Medicare available.

    Does anyone know if ACA-compliant coverage counts as creditable part B to avoid part B LEP in this situation?
     
    Last edited: Jun 3, 2016
  3. melmadhav
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    Thxs so much! I couldn't find the actual Medicare.Gov link but found other sites confirming my thoughts. Thank you for sharing, I feel way more comfortable advising when it comes from medicare.gov!
     
  4. agentjhc
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    If it's credible coverage (ACA plans should be) there shouldn't be a LEP
     
  5. melmadhav
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    Her spouse has employer insurance and she isn't eligible for ACA, but thank you! He wanted to compare Medicare vs. Employer is the reasoning behind the question.
     
  6. TN_agent
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    Logic dictates ACA SHOULD be creditable for Medicare, but sometimes reality + government regulation=ridiculous. Plus getting them to save proof forms or even get sent a form will be tricky, especially if their company goes out of business (hello co-ops!)

    In some crazy ridiculousness, if someone is eligible for VA coverage, they aren't eligible for an ACA subsidy. This same person presumably could be in the OP situation and be T65 and not qualify based on work record for premium-free part A.

    They need to sign up for Medicare B, though, because VA coverage is considered compliant/creditable in terms of avoiding tax penalty and part D, but not for avoiding Part B LEP later on.

    I think. Maybe. I don't have a clue.

    Trying to advise what is best for the client within the soup of

    VA/ACA/A+B/SLMB/LIS/LEP/SEP/COBRA/GI/OEP/AEP/QMB/SNP/F vs G

    is making me insane.

    ----------

    ah, well that answers that. Employer is probably going to be a LOT cheaper over Premiums for A+B+D. Assuming it isn't a $6000k HDHP. Oh look, another acronym to add to my soup for flavor.
     
  7. WCMason
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    Only employer coverage (actively employed self or spouse) is creditable to avoid Part B LEP
     
    WCMason, Jun 5, 2016
    #7
  8. Brian F 11
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    Best thing you can do is contact your upline and they will contact the carrier directly

    You can also call Medicare

    Sent from my iPhone using InsForums
     
  9. WCMason
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    I've not found carriers or Medicare phone reps to be consistently accurate sources of information. The likelihood of getting more than one answer is not uncommon. CMS publications, like the one linked above, are great sources.

    A person not eligible for Medicare under his or her own earnings can qualify under a spouse who has the required 40 credits, but the spouse has to be at least 62, as the CMS publication states. I have one client who waited until 67 to get Medicare because a rep at the SSA office wrongly told her she had to wait until her husband turned 65 to qualify under his earnings.
     
    Last edited: Jun 8, 2016
    WCMason, Jun 8, 2016
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