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

Question

Brian Moore · Accepted Answer

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

Mark Maliwauki · Answer

If you are 65 you will have to go on Medicare. You have 63 days to get on Original Medicare A&B or chose a Medicare Supplement or Medicare Advantage plan.

Nikki Rowland · Answer

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.

Mark Cunningham · Answer

Losing a spouse can have significant implications for your health coverage under Medicare, especially if you were covered under their employer-sponsored plan. Here’s what typically happens:
1. Loss of Employer Coverage - If your spouse’s employer coverage was what provided your health insurance, losing this coverage may qualify as a "Special Enrollment Period" (SEP) for Medicare. This allows you to enroll in Medicare outside of the usual enrollment periods without facing late enrollment penalties.
2. Enrolling in Medicare Part B - If you were previously delaying Medicare Part B because of coverage from your spouse's employer plan, you will need to enroll in Part B within eight months of losing that coverage to avoid a penalty. The SEP gives you the flexibility to do this without waiting for the General Enrollment Period.
3. Medicare Supplement Plans or Part C - You may also consider enrolling in Medigap (Supplemental Insurance) or a Medicare Advantage (Part C) plan to cover additional costs, depending on your needs.
4. Prescription Drug Coverage (Part D) - If your spouse’s employer coverage provided prescription drug benefits, you may need to enroll in a Part D plan if you don't already have one. You will have a SEP for this as well.
5. Documentation and Timing - Ensure you have proof of losing employer coverage (like a letter from the employer or insurance provider) when applying for Medicare through the SEP.
It's recommended to contact Medicare or a licensed advisor promptly to ensure that you transition seamlessly and avoid lapses, penalties, or gaps in coverage. Additionally, exploring other benefits, such as COBRA, may be an option during this transition.

Joshua Cooper · Answer

If you were on their employer plan and are getting kicked off the plan you get a special enrollment opened up so now you can enter either a Medicare Supplement or a Medicare Advantage plan

Jeffrey Fraas · Answer

In most cases if you were on employer coverage you would lose that coverage and would qualify for a Special Enrollment Period to enroll in Original Medicare Part A & B and Part D with a Medigap plan or choose a Part C Medicare Advantage plan if you are Medicare eligible (Age 65). Also your employer coverage including drug coverage would have had to been creditable coverage compared to Medicare health insurance. If not then there may be late penalties for Part B and Part D Medicare coverage.

Answered by Jeffrey Fraas on June 13, 2025

Agent Licensed in TN, KY, MO & TX

Answered by Jeffrey Fraas Medicare Insurance Agent

Steven Bleicher · Answer

The more important question is: Since you are going to receive only the higher dollar value of your respective Social Security deposits, by LOSING the smaller amount, how will that loss affect the paying of your expenses? Since you are entitled to a Special Election Period (SEP) in losing the employee plan, you will be able to choose any plan you desire (without answering any medical questions), between the Medicare Supplement, aka a Medigap plan, or a Med. Advantage plan. If you have health issues, the Medigap is the better choice, even though it contains a monthly premium.

Answered by Steven Bleicher on May 26, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

Losing your spouse while covered by their employer-sponsored coverage means a couple of different things.

One - if they are still working, you will lose your insurance coverage. Two - if they are retired and you are both covered under an employer-sponsored retirement insurance plan, it will all depend on how the plan is set up.

The way to handle it:
1) If you are eligible for Medicare and your spouse's employer-sponsored coverage ends, you will have a Special Enrollment Period (SEP) to enroll in Medicare Parts A and B. If you were only covered under your spouse's employer plan, you'll need to take action to ensure continuous coverage. That means signing up for Medicare Part A and B as well as electing other coverages for what Medicare Part A and B do not cover such as a Medicare Supplement with a Prescription Drug plan or Medicare Advantage plan.

2) If you already have Medicare A and B, you will have a Special Enrollment Period (SEP) to enroll in a Medicare Supplement with a Prescription Drug Plan or a Medicare Advantage plan with Prescription Drug coverage included.

Michael Pyers · Answer

Varies by Employer, please contact you spouses HR department at his work.  You may need to get a new plan, but you will have a limited time to sign up for a new plan!

John L Herman Jr · Answer

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

Gary Henderson · Answer

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

Steve Brauer · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/how-does-losing-a-spouse-impact-my-medicare-plan-if-i-was-on-their-employer-coverage#steve-brauer

Andrew Kramer · Answer

If you are on an employer sponsored plan, either a supplement to original Medicare, or an Advantage plan, that question needs to be posed to the insurance sponsor. Usually, plans are individual to each spouse. But it needs to be confirmed if the spouse of the other spouse who initiated that plan, can keep the plan after that spouses death. Not a simple answer.

Answered by Andrew Kramer on June 24, 2025

Agent Licensed in FL

Answered by Andrew Kramer Medicare Insurance Agent

Suzanne Lamperti · Answer

It presents an SEP and you can apply for Medicare and a supplement possibly with guaranteed issue.  Check with Medicare.

Natalee Nimmo · Answer

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.

Kerwyn Jones · Answer

Dramatically!  You are now without coverage and need a new plan. A discovery needs to be completed and then an enrollment.

April Ryan · Answer

Losing a spouse is devastating in itself, having to figure out insurance and other bills adds to the stress. We try to take away the stress by handling these life qualifying events for our clients. If you lose a spouse and was on their employer coverage, you have 63 days to enroll in Medicare without a penalty. It’s considered a qualifying event, which means you would need to enroll in Medicare Part A & Part B, and we would work with you to determine the best Medigap plan for your needs.

Answered by April Ryan on June 9, 2025

Broker Licensed in NC, SC & VA

Answered by April Ryan Medicare Insurance Agent

Rick Ried · Answer

Since you have lost the employer plan through your spouse's work, it creates a special enrolment period that allows you to obtain coverage under Medicare if you are eligible for Medicare.

Jeannie Pond · Answer

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

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

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A non-government resource website