Medicare and Divorce

by Stephanie Dube Dwilson
Some elderly couples divorce to get lower premiums.

Some elderly couples divorce to get lower premiums.

Siri Stafford/Digital Vision/Getty Images

Health insurance coverage based on your spouse can sometimes last far beyond the length of the marriage itself. If you're divorced and approaching the age where you qualify for government-sponsored Medicare, your former marriage may help you obtain coverage.

Medicare

Medicare is a health insurance plan offered by the federal government for people who are age 65 and older, or for some younger people who have certain illnesses. Medicare Part A, hospital coverage, is free. Part B, medical insurance, is available for an extra monthly premium based on your income. Part C, the advantage plan, is for people who want even more options. These can include a preferred provider organization plan with more doctors in network or a fee-for-service plan. Medicare also has a prescription drug plan for a small additional cost.

Qualifications After Divorce

Typically, a person qualifies for Medicare at the age of 65 if he worked about the equivalent of 10 years and also qualifies for Social Security. If you didn't work enough to qualify and are divorced, you may still qualify based on your ex-spouse's work record. If your ex-spouse qualifies for Medicare, you're 65 or older and were married for at least 10 years, you can get coverage through your former spouse. If you've remarried since your divorce, however, you no longer qualify for Medicare based on your ex-spouse.

Cost-Based Divorces

Medicare's coverage options for divorced spouses may indirectly encourage some spouses to break up. Medicare Plan A only covers the most basic services. It doesn't cover long-term rehabilitation, assisted living, at-home nursing or clinical trials. Medigap policies, which help fill in the gap that Medicare doesn't cover, often charge premiums based on a person's income. It's not unheard of for spouses to choose to divorce so that the sick spouse can have an income of zero and qualify for cheaper Medigap premiums, even if he's qualifying based on his divorced spouse's work history.

Divorce's Impact on Income

If you're receiving any type of Medicare besides the free Plan A version, you are likely being charged premiums based on your income. The basis may be calculated according to your income from two years prior. If you've divorced and your income decreased as a result, you may qualify for a lower premium. To get the government to look at evidence besides your last two years of income, you can request a new decision based on a life-changing event and provide proof of your life-changing event to qualify.