How does losing a spouse impact my Medicare plan if I was on their employer coverage?

Answered by 8 licensed agents

When a client loses a spouse and was on their employer coverage, I explain they have 63 days to enroll in Medicare or adjust their plan without facing a penalty. It’s a qualifying event, so they’d need to switch to their own Part B if they’re 65, and I’d urge them to do it promptly to avoid any cost hikes or coverage lapses. The rules give them a clear path forward, but timing is critical.

Answered by Brian Moore on March 26, 2025

Broker Licensed in OH

Answered by Brian Moore Medicare Insurance Agent
If you are unable to keep the coverage from the spouse's employer, you would have a SEP Special Enrollment Period to the enroll into a new plan. This would be person and situation specific.

Answered by Nikki Rowland on April 11, 2025

Broker Licensed in SC & NC

Answered by Nikki Rowland Medicare Insurance Agent
It means that if you are 65 you now have 6 months to get your new MEDICARE PLAN. First find out how long the current insurance lasts and then sit with an Independent Broker to see what options you have.

Answered by John L Herman Jr on April 14, 2025

Broker Licensed in MD, DE & PA

Answered by John L Herman Jr Medicare Insurance Agent

Answered by Steve Brauer on April 21, 2025

Broker Licensed in AZ & CA

Answered by Steve Brauer Medicare Insurance Agent
Well you need to explain this. Are you also losing your spouse's coverage? The answer depends on a lot more detail. Sorry, I can't explicitly answer this one, but if you do lose your spouse's coverage and you're on Medicare, you're still always covered by Medicare. That doesn't change unless you stop paying your Medicare part b payment and you lose part b

Answered by Gary Henderson on April 19, 2025

Agent Licensed in TX, AK, AL & 46 other states

Answered by Gary Henderson Medicare Insurance Agent
Dramatically! You are now without coverage and need a new plan. A discovery needs to be completed and then an enrollment.

Answered by Kerwyn Jones on April 8, 2025

Broker Licensed in FL, AL, AR & 21 other states

Answered by Kerwyn Jones Medicare Insurance Agent
Well that’s gonna depend on the employer. You would need to talk to someone in their HR department and see if you’re gonna be able to remain on the employer plan and if not, they will let you know and give you a certain timeframe to switch to a different plan. Once you find out whether or not the employer is going to allow you to remain on it or not, even if they are going to allow you to remain on it, I would still talk to a broker and get all your information together on the employer plan for the agent or broker so they can give you an accurate comparison with real dollars and facts. This way you’ll be able to make a more informed choice and decision for yourself.

Many times the employer plans are good but if you were to get a Medicare & Medicare supplemental plan, those plans usually end up to be better coverage. That doesn’t always happen, but it happens probably majority of the time.

Answered by Natalee Nimmo on April 8, 2025

Broker Licensed in SC, FL, GA & KY, MO, NC & TX

Answered by Natalee Nimmo Medicare Insurance Agent
Losing your spouse is devastating and can significantly affect your health insurance coverage, especially if you were covered under their employer's plan. Knowing your resources or having a trusted broker agent can ensure that you will remain covered.

Things to know:

1. Impact and Timeframe to make a change: When your health insurance was through your spouse’s employer, the policy will typically be canceled. You should get informational packets from the employer explaining your timeframe. When coverage is terminated, a Special Election Period (SEP) opens giving you a two-month window to enroll in a Medicare Avantage Plan or a Medicare drug plan, according to https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan/special-enrollment-periods?.

2. COBRA as a possible option: You might be eligible for COBRA which typicall lasts up to 36 months in these circumstances. Keep in mind that COBRA can be pricey. You should also note that if you become eligible for Medicare, COBRA may only pay a small portion of our medical costs. You might wind up being responsible for the majority of the costs of treatment. https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65/cobra-coverage?

3. If you're 65 or older and lose your spouse's employer coverage, you should enroll in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance) during your SEP to avoid late enrollment penalties. Delaying enrollment could result in penalties and gaps in coverage.

What should you do?

1. If you haven’t already done so, reach out to Social Security to inform them of your change in circumstances and to initiate the Medicare enrollment process if you haven't already done so. SocialSecurity.gov allows you to see if you are enrolled and also if you are eligible for your spouse’s benefits.

2. Since you have developed a relationship with your insurance agent, they will be able to compassionately compare the costs and benefits of

Answered by Jeannie Pond on April 9, 2025

Agent Licensed in FL, AZ, IN & NC, TN, TX & VA

Answered by Jeannie Pond Medicare Insurance Agent

Tags: Coverage New To Medicare

Agents: Share Your Expertise

Have insights or experiences related to this topic? Help others by sharing your knowledge and answering this question.

Add Your Answer