When you and your spouse reach Medicare age, it’s essential to understand how your coverage should work as a couple. Many people assume that Medicare and Medigap work like employer insurance, where one family plan can cover both spouses. But Medicare does not work that way.

That doesn’t mean you and your spouse should plan everything separately. This Medicare Supplement broker in La Porte, Indiana is going to explain how married seniors can coordinate their Medicare coverage below.

Why can’t couples share one Medigap policy?

There are no joint or family Medigap policies. Even though it is convenient to have one shared policy, Medigap rules require each spouse to enroll individually.

But this is not necessarily a drawback. Having individual plans gives each spouse the flexibility to choose the best coverage for their needs. For example, one spouse may need more benefits because they regularly see specialists while the other spouse may prefer a cheaper option because they rarely visit a doctor.

Medigap benefits are standardized but premiums can be very different from company to company. Choosing different plans can help you better manage your household budget. A good Medicare Supplement broker in La Porte, Indiana can help you compare options and decide which plans look the best for each of you.

How do benefits work if one of us is still working?

If you or your spouse is still covered by employer health insurance, you may be able to delay signing up for Medicare without facing late enrollment penalties.

In many cases, the working spouse can postpone enrolling in Medicare Part B until the employer-provided group health plan ends (for whichever spouse is covered). At that point, they can use a Special Enrollment Period (SEP) to sign up for Part B without a penalty. Meanwhile, the retired spouse who becomes Medicare-eligible at age 65 can enroll in Original Medicare and buy a Medigap policy once they have Part B.

How do we coordinate when we are both on Medicare?

Once both spouses are on Medicare, coordinating coverage becomes more about strategy than timing. You will still have two separate policies but now you can plan as a team.

First, as we mentioned earlier, choosing different plans can give couples more control over their total household spending without giving up necessary protection.

Couples should also think about their long-term needs. Even if one spouse is healthy now, that can change in the future. And because Medigap enrollment outside the initial enrollment period or a guaranteed-issue right can involve medical underwriting, it can become more difficult or expensive to switch to a more comprehensive plan in the future.

How does Medicare work when one of us has retiree or employer coverage?

In most cases, when someone has both Medicare and retiree coverage, Medicare pays first. Because Medicare becomes the primary payer, you should review how the retiree plan coordinates with Medicare. Be sure to check if medical or prescription benefits will change if you get a Medicare or a Medigap plan.

If a spouse delays enrolling in Medicare Parts A and B because they are on an employer or retiree plan, they risk triggering the standard late-enrollment rules once that coverage ends. The Special Enrollment Period is an 8-month window that starts when employment-based coverage ends or when the spouse stops working. Missing that window can lead to a permanent penalty for late Part B enrollment.

What steps can couples take to coordinate their Medicare coverage?

The best way to approach Medicare as a couple is to think of your coverage as two individual plans that should work together to support your household. Start by reviewing each spouse’s current and future healthcare needs. Then evaluate your monthly budget and how both plans fit into it. For example, you could choose a higher premium plan for the spouse with more medical needs and a cheaper plan for the spouse who is physically healthy.

You should also plan for what’s ahead. If one spouse is nearing retirement, coordinating that transition early can prevent coverage gaps. And if a spouse is approaching age 65, make sure you understand their Medigap Open Enrollment Period. This is one of the easiest times to get a Medigap plan without underwriting.

Couples who are still confused should consider reviewing everything with a professional Medicare Supplement broker in La Porte, Indiana.

Looking for a Medicare Supplement broker in La Porte, Indiana?

If you and your spouse want help coordinating your Medicare and Medigap coverage, you can always turn to an experienced Medicare Supplement broker in La Porte, Indiana for advice. That’s where Senior Care Insurance Services comes in. Our licensed agents can help you and your spouse compare plans and discuss enrollment timelines. Contact us today to speak with an agent.