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Health Insurance Options for Pre-Medicare Spouses
By Jim Miller
Unfortunately,
Medicare does not provide family coverage to younger spouses or dependent
children when you qualify for Medicare. Nobody can obtain Medicare
benefits before age 65, unless eligible at a younger age because
of disability. With that said, here are some options for your wife
depending on your situation.
Work longer: If possible, you should consider working past age 65 so your wife
can continue coverage under your employer health insurance until she becomes
eligible for Medicare, or, if that’s too long, at least for a few more
years.
Check employer options: If your employer provides retiree health benefits, check
with the benefits administrator to find out if they offer any options that would
allow your wife to continue coverage under their plan. Or, if your wife works,
see if she can she switch to health insurance provided by her own employer.
Use COBRA: If you work for a company that has 20 or more employees, once you
make the switch to Medicare, your wife could stay with your company insurance
plan for at least 18 months (but could last up to 36 months) under a federal
law called COBRA. You’ll need to sign her up within 60 days after her last
day of coverage. You also need to know that COBRA is not cheap. You’ll
pay the full monthly premium yourself, plus a 2 percent administrative fee.
The other benefit of using COBRA is that once it expires, your wife will then
become eligible for HIPAA (Health Insurance Portability and Accountability Act),
which gives her right to buy an individual health insurance policy from a private
insurer that can’t exclude or limit coverage for pre-existing medical conditions.
To learn more about COBRA, visit askebsa.dol.gov or call 866-444-3272.
If, however, the company you worked for had fewer than 20 employees, you may
still be able to get continued coverage through your company if your state has “Mini-COBRA” (39
states offer it). Contact your state insurance department (see naic.org) to see
if this is available where you live.
Buy an individual policy: This is health insurance you buy on your own, but it
too can be expensive depending on your wife’s health history. Any pre-existing
condition such as heart disease, diabetes, cancer, etc., can drastically increase
her premiums or can nix her chances of being accepted at all. To search for policy
options and costs go to healthcare.gov. If you need help, contact a licensed
independent insurance agent. See www.nahu.org/consumer/findagent.cfm to locate
one near you.
Or, if you only need health coverage for a short period of time — less
than 12 months — a short-term policy is another lower-cost option to consider.
You can get quotes and coverage details at ehealthinsurance.com.
Get high-risk coverage: If you can’t purchase an individual health policy
for your wife because of a pre-existing medical condition, you can still get
coverage through a state or federal high-risk pool.
State pools, which are offered in 35 states (see naschip.org), provide health
insurance to any resident who is uninsurable because of health problems. While
costs vary by state, premiums run about 150 percent of what an individual policy
costs.
Or, consider the federal Pre-Existing Conditions Insurance Plan (see pcip.gov)
which is available nationwide. Created in 2010 under the health care reform law,
this program is intended to bridge the gap until better options become available
in 2014 when the main provisions of the law go into effect. To qualify, your
wife must be uninsured for six months before applying.
This page and its contents ©2012
Metropolitan News Company, Inc.
