how Medicare works Archives

Will You & Your Spouse Be On The Same Medicare Plan?

You and your spouse are probably used to doing a lot of things together. While you were working, healthcare was probably one of the things that you participated in jointly. If you had an individual or employer-based insurance plan, you and your spouse were probably on one plan, which helped you to save money. So now that the time has come to enroll in Medicare, you might be wondering whether you can save money by being on the same Medicare plan. Because Medicare works differently from private insurance, the short answer is no. Medicare plans are issued on an individual basis, so you and your spouse cannot be on one plan.

How Medicare Works

medicare enrollment form with a pen laying on it — *You can delay Medicare Part B if you are working, and then enroll later without a penalty.*

Some people are automatically enrolled in Medicare Part A, and others have to sign up for it manually. In most cases, this depends on whether you’re already receiving your Social Security benefits. If you are 65 and collecting Social Security, then you will automatically be enrolled into Medicare Part A. If you decide to hold off on collecting Social Security, then you will have to manually enroll in Medicare Part A when you turn 65.

Because Medicare Part B has a monthly premium, it is optional; this means you will have to sign up for it yourself during your Initial Enrollment Period (the 3 months before you turn 65, the month you turn 65, and the 3 months after you turn 65). If you do not enroll in Part B during your Initial Enrollment Period, then you will face a late penalty for every year you push off Part B enrollment. If you are still working at 65, then you can opt out of Medicare Part B enrollment without facing a penalty fee, as long as your employer has 20 or more employees.

Both Medicare Parts A and B are plans for one individual person, offered by the government and paid for by the taxes you contributed while you were working. Even if your spouse is already enrolled in Medicare when you turn 65 and enroll in Medicare yourself, your plans will not be connected. As mentioned above, Medicare does not work in the same way as a private health insurance plan, which would allow you to join your spouse’s plan and receive the same benefits. Everyone enrolled in Medicare Parts A and B receives the same benefits; the differences in coverage comes when you choose to enroll in Medicare Advantage or a Medicare Supplement Plan.

Medicare Supplement Plans

money bills rolled up in a rubber band — *Medicare Supplement Plans will help you save on medical expenses based on your individual needs.*

Medicare Parts A and B are individually issued by the government; Medicare Advantage plans and Medicare Supplement Plans are private plans but are also connected to one individual beneficiary. Unlike Original Medicare, though, the coverage they offer differs from plan to plan and person to person. Each Medicare Supplement Plan will have different access to healthcare providers and different networks. What works for one person might not work for another. Because Medicare Part B only covers 80% of costs, many Medicare beneficiaries choose to enroll in a Medicare Supplement Plan to reduce their out-of-pocket costs.

Medicare Supplement Plans are only sold on an individual basis, so you and your spouse will need to purchase separate plans, and may be offered different coverage depending on your needs. If you get a Medicare Supplement Plan through the same company, though, you might be able to take advantage of household discounts. Some companies will offer a discount if one or more members in your household have a plan from the same company.

When Choosing A Plan

Even if you could enroll in your spouse’s Medicare plan, doing so would not provide any extra benefits for you. All Original Medicare plans offer the same benefits, and the beauty of Medicare Supplement Plans is that there are 10 to choose from, so you can get benefits tailored to your needs. But in order to get maximum coverage and to save money, you will have to compare plans and research your options to determine which plan will best fit your financial and medical situation. For example, when looking for a Medicare Supplement Plan, you should talk to your doctors to make sure that they accept Medicare assignment and that they are in each plan’s network.

When you are ready to enroll in Medicare, contact an EZ Medicare agent. We want to make sure you can continue seeing your doctors, getting your medications, and being treated for any conditions. We also want to make sure that you can save money while doing so! We will research all possible options in your area and provide you with quotes so you can make an informed decision for your healthcare needs. All of our services are free, and there is no obligation to sign up. We want to help you get covered! To compare plans in minutes, enter your zip code in the bar above, or to speak to a licensed agent, call 888-753-7207.

Medicare When Self-Employed

For many people, turning 65 and starting to collect Social Security means being automatically enrolled into Medicare. There are exceptions to this and ways to put off enrolling into Medicare, such as if you are still working and have health insurance through your employer. But what happens when you are self-employed and you’re about to turn 65? Do you have to sign up for Medicare, or can you delay enrolling without facing a penalty? Being self-employed impacts your Medicare options, so it is important to understand how you can be fully insured and avoid any penalties.

How Medicare Works

the numbers 65 as candles that are lit — *Normally, if you are collecting Social Security, then you will be automatically enrolled into Medicare when you turn 65.*

Self-employed or not, as long as you have been paying income taxes in the U.S., you will be automatically enrolled in Medicare Part A when you turn 65, but only if you are already receiving Social Security. If you are not receiving Social Security, then you will need to manually sign up for Medicare during your Initial Enrollment Period, which is the 3 months before your 65th birthday, the month of your 65th birthday, and the 3 months after your 65th birthday. You can sign up for Medicare Parts A and B at this time or you can choose to opt out of Part B; it is optional because it has a premium. If you decide to enroll in Part B later, though, you will pay a penalty on your premium for as long as you have Medicare. If you do decide to enroll into Medicare and you are still self-employed, then Medicare will be your primary insurance.

Self-Employed With Marketplace Plan

If you are (or were) self-employed, you might have a Marketplace insurance plan if you aren’t covered by your spouse’s employer-based plan. When you turn 65, you have the option to cancel your Marketplace plan without a penalty and join Medicare, or you can choose to keep your Marketplace plan. If you do decide to keep your health insurance plan, then it will become secondary to Medicare, meaning Medicare will be your primary payer. Be aware that having a Marketplace plan does not qualify you to delay enrolling in Medicare without a penalty, so you will have to enroll in Medicare during your Medicare Initial Enrollment Period when you turn 65 in order to avoid paying extra on your Part B premiums.

Self-Employed With Employer-Based Coverage

older caucasian man working on a saw table — *If you are enrolled in an employer’s health plan, then you can wait to enroll into Medicare without penalty.*

If you don’t have a Marketplace plan, but are covered through another job you have or through your spouse’s plan, then you might be able to wait to enroll into Part B and not face a penalty. If you or your spouse’s workplace has fewer than 20 employees, you will be required to sign up for Medicare at age 65, but if it has fewer than 20 then you will not have to.

The number of employees at you or your spouse’s workplace also determines which insurance plan will be your primary payer. If you or your spouse’s workplace has 20 or more employees, the employer-based plan will be primary. If you sign up for Medicare and you also have an employer-based plan through a business with less than 20 employees, then your employer’s health plan will become secondary coverage after Medicare.

Self-Employment & Medicare Premium Deductions

Since 2012, the IRS has allowed self-employed individuals to deduct all Medicare premiums from their federal taxes. This includes Medicare Part B and Medicare Part A premiums, Medicare Supplement Plan premiums, and your spouse’s Medicare premiums. When deducting your Medicare premiums, your premium payments are subtracted from your gross income, which is different from doing an itemized deduction for medical expenses that are taken after your adjusted gross income (AGI) is calculated. In order to deduct your premiums, you have to report a profit from your business.

Using Your HSA

If you are 65 or older and self-employed, you can open and contribute to an HSA as long as you meet these HSA eligibility requirements:

You’re covered by a HSA-qualified medical plan.
You’re not someone’s tax dependent.
You don’t have any conflicting coverage (including being enrolled in Medicare).

If you are enrolled in Medicare then you can no longer contribute to your Health Savings Account (HSA). However, you can continue to withdraw money tax-free from the account and use it to help pay your Medicare premiums, deductibles, copays, and coinsurance.

Understanding how Medicare works can be tricky. You need to make sure that you have all of your bases covered so you are insured and do not receive any surprise bills. EZ.Insure will go over all of your options and make sure that you are prepared to transition to Medicare, and we can sign you up for a Medicare Supplement Plan for extra savings if need be. To get instant, free quotes, enter your zip code in the bar above, or to speak to one of our licensed agents, call 888-753-7207.