Need to Know
- Your Medicare coverage is individual, so you and your spouse enroll separately and pay premiums based on combined income, not as a couple.
- If you’re widowed or divorced, you may still qualify for free Medicare Part A using your spouse’s work history if certain marriage duration rules are met.
- Medicare Advantage and Part D plans have separate costs and enrollment periods for each person, even if you choose the same plan as your spouse.
This summary was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
The good news about marriage and Medicare is that your coverage won't change. Neither will your spouse's.
Whether you're already married, thinking about getting married, or no longer married, here's what you need to know.
Medicare if You're Married
You and your spouse's Medicare coverage might not start at the same time. Unless you are disabled, you are generally eligible for Medicare when you are age 65. Medicare is an individual plan (there is no family plan). However, you may be eligible for Medicare based on your spouse’s work history -- even if you are not eligible on your own. You and your spouse's Medicare coverage might not start at the same time. Since you each must enroll in Medicare separately, one of you may be able to sign up before the other one, depending on your age.
Your premiums may change because of your total income. There are no family plans or special rates for couples in Medicare. You will each pay the same premium amount that individuals pay. Here's what to know about costs:
- Medicare Part A, hospital coverage, has no monthly cost for most people who worked or have a spouse who worked and is eligible for Social Security. The other parts of Medicare do have premiums.
- For Medicare Part B, outpatient medical coverage, your premium is based on how much you and your spouse earn together. Most people pay the standard premium, which is $202.90 per month in 2026. If you are single and earn more than $109,000 or married and earn more than $218,000 per year, you'll pay each month for Medicare.
- For Part C (Medicare Advantage), you and your spouse will have your own premium, deductible, and copays. This is true even if you have the same plan. A Medicare Advantage plan is a type of plan offered by a private insurance company to provide you with all your Medicare Part A and Part B services. You may be charged a separate premium by the insurance company in addition to your Part B premium and may be eligible for additional benefits, including prescription drugs. You may be required to use the plan’s network of health care providers. You can only enroll in a Medicare Advantage when you first become eligible for Medicare (a 7-month period that starts three months before you turn 65, includes the month of your birthday and ends 3 months after) or during the annual open enrollment period from Oct. 15 to Dec. 7 each year. For Medicare Part D, prescription drug coverage, plans vary and so do the premiums. Even if you and your spouse pick the same plan, you'll each have to meet the deductible before Medicare starts to pay anything toward your health care. You can only enroll in a Medicare Part D plan when you first become eligible for Medicare or during the annual open enrollment period from Oct. 15 to Dec. 7 each year.
Medicare if You're Widowed or Divorced
If you do not qualify for free Medicare Part A based on your own work history, you can qualify based on your spouse’s work history, even if you are widowed or divorced. If divorced, you must have been married for at least 10 years. If widowed, you must have been married for at least nine months. Once you turn 65, you are eligible for free Medicare Part A through your former spouse, as long as they worked at least 10 years and paid Medicare taxes during that time. You can apply for Medicare online or through your local Social Security office beginning three months before your 65th birthday, the month of your birthday, and for three months after your birthday month.
You will still need to pay premiums for the other parts of Medicare coverage as described above.
Special Enrollment Period (SEP)
People who have been covered under an employer group health plan through their own or their spouse's current employment can delay their enrollment in Part B without penalty. If your spouse dies and you were covered under their employer or union group health plan, you get an 8-month Special Enrollment Period to sign up for Medicare Part B, starting the month after your spouse's death or the date their employer coverage ends, whichever comes first.
COBRA continuation coverage after a divorce or death is not considered "creditable" employer coverage for Medicare purposes, so even though you can elect COBRA for a temporary bridge, it doesn't extend your SEP window. The clock runs from when the actual employer-sponsored coverage ends, not from when COBRA runs out.
