Key takeaways
- While Medicare doesn’t offer family plans, a spouse may qualify for Medicare based on their partner’s work record, even if they haven’t worked themselves, provided they are 65 or older or have a disability. This can also apply to divorced spouses if the marriage lasted at least 10 years.
- To qualify for Medicare based on a spouse’s work record, individuals typically need to have accumulated 40 Social Security work credits, which is equivalent to approximately 10 years of employment. However, those with disabilities may require fewer credits.
- If one spouse is eligible for Medicare and the other isn’t, the younger spouse has options, such as enrolling in their own employer’s plan, COBRA, or the Affordable Care Act. A special enrollment period is triggered by the loss of spousal coverage.
If a person meets certain requirements, they may qualify for Medicare using their spouse’s eligibility. However, because Medicare is an individual health insurance program, each spouse must enroll in a separate Medicare plan.
This article examines the eligibility criteria for the spouses of Medicare enrollees for coverage.
Glossary of Medicare terms
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
With some exceptions, to enroll in Medicare, a person must have worked and paid Social Security taxes in the United States for at least 40 quarters.
A married person who does not have this work history themselves can become eligible for premium-free Medicare Part A at age 65 as long as they are a U.S. citizen or resident, and they are:
- married to a spouse 62 years and older who is receiving or is eligible to receive Social Security or Railroad benefits for at least one year before the person applies for their own benefits.
- If divorced, they were married for at least 10 years to an eligible spouse, and they are now unmarried.
- If widowed, they were married for at least nine months before their spouse’s death, and the deceased spouse was eligible. The person must also be currently unmarried.
Can a spouse under age 65 get Medicare?
Before age 65, a spouse can get Medicare if they themselves qualify for Medicare based on receiving disability benefits, or they are married to an eligible spouse and receiving dialysis for end stage renal disease.
When a person works and pays taxes in the United States for the required 40 quarters, they will earn 40 work credits, which equals about 10 years of employment.
In 2025, workers receive one work credit for every $1,810 they earn, an amount that will adjust in 2026. A person can earn up to four credits annually. Self-employed individuals also receive up to four annual work credits per $1,810 of net earnings.
As long as a person’s spouse has earned enough credits, they will be eligible at age 65 and can enroll in Original Medicare. But spouses receiving Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) benefits may need fewer work credits to qualify themselves and their partner.
For example, a spouse who develops a disability between the ages of 31 and 42 will require 20 work credits for Social Security disability benefits. On the other hand, a spouse who develops a disability at age 62 will require the full 40 credits to qualify for Social Security disability benefits.
A person eligible for Medicare based on their spouse’s eligibility can apply online through Medicare.gov, where they can also track their application.
Alternatively, they can call the Social Security office at 800-772-1213 (TTY 800-325-0778) Monday through Friday, or visit their local Social Security office in person.
It is important to know that if a person’s spouse is eligible based on a disability, the spouse will be automatically enrolled in Medicare after 24 months. However, the person may need to manually enroll to get their own plan.
Once a person enrolls in Medicare Part A, they can also enroll in Medicare Part B, which together comprise Original Medicare. They can then also switch to Medicare Advantage (Part C) and enroll in Medicare Part D or Medigap by contacting insurers administering specific plans in their area.
When choosing a plan, a person may consider provider networks, costs, and quality ratings. A person has the option to join a plan or modify their coverage during one of the following enrollment periods:
- Initial enrollment: Enroll 3 months before to 3 months after the month of their 65th birthday.
- Open enrollment: Join or change plans from October 15 to December 7.
- Medicare Advantage open enrollment: Switch Medicare Advantage plans or return to Original Medicare from January 1 to March 31.
- Special enrollment period: Enroll after a qualifying life change, such as losing job-based coverage.
In order to get Medicare, a non-working person must qualify either independently based on their own employment history, age, or disability, or based on their spouse’s employment history, age, or disability. However, they will have to enroll in their own Medicare plan, separate from their spouse’s.
That said, if a person’s spouse does not meet eligibility criteria and the person does not qualify for premium-free Part A on their own, they can still purchase Part A for a monthly premium. Once they have Part A, they can also get Medicare Part B.
Each spouse pays their own Medicare premiums since Medicare coverage is individual. Premium amounts are based on a person’s income and work history.
A person may not qualify to enroll in Medicare based on their spouse if they have been married for less than a year since the eligible spouse applied for their own benefits, or they were married for less than 10 years prior to divorcing, or less than nine months before their eligible spouse’s death.
In this case, a person may need to consider remaining on an employer’s insurance plan if they are still working, using the Consolidated Omnibus Budget Reconciliation Act (COBRA) to extend their coverage, or purchasing a plan from the Health Insurance Marketplace.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
At 65, a U.S. citizen or resident may qualify for premium-free Medicare Part A based on their spouse’s work record if they’ve been married to an eligible spouse for at least one year, are divorced after at least 10 years of marriage, and currently unmarried, or are widowed after at least nine months of marriage to a spouse who was eligible for Medicare. However, they will have to enroll in their own separate Medicare plan.