Medicare for Couples: Why You Can’t Share a Plan

Posted by Pattie Scoma
Estimated Reading Time 1 minute 39 seconds

When couples begin planning for retirement, it is natural to assume that Medicare works like employer health insurance, where both spouses can be covered under one plan. However, Medicare does not offer family or joint coverage. Each person must enroll separately and have their own plan. Understanding why this is the case and how to navigate your options can help you make the most of your coverage and avoid costly surprises.

Individual Coverage, Not Family Plans

Medicare is designed as an individual health insurance program. Eligibility is based on a person’s age or disability status, not on marital status or household. When you turn 65, you qualify for Medicare based on your own work history or that of your spouse. Once enrolled, your coverage is entirely your own. This means that you will have your own monthly costs, deductibles, and out-of-pocket limits that do not combine with your spouse’s.

For example, if one spouse qualifies for premium-free Part A (hospital insurance) because of work history, the other spouse may also qualify when they turn 65. However, that second spouse must still enroll separately and cannot join the same plan.

Coordinating Medicare Choices as a Couple

Even though you cannot share a plan, it is still smart to coordinate your choices. Each partner may have different healthcare needs or prescription requirements, so the best plan for one spouse might not be ideal for the other. For instance, one partner may prefer Medicare Advantage, while the other might prefer Original Medicare with a Medigap supplement for broader provider access.

If you both take prescription medications, reviewing Part D drug plans separately is also important. Drug formularies can vary, and a plan that covers one spouse’s prescriptions at a low cost might not be the best fit for the other.

How to Make the Right Choices

Couples can maximize your budget and avoid confusion by reviewing their options together during Medicare’s Annual Enrollment Period, which runs from October 15 to December 7 each year. A licensed insurance broker can help both of you review plans side by side and ensure you each get the right coverage based on your needs.

Get Knowledgeable Guidance

Our experienced licensed insurance brokers specialize in helping couples navigate Medicare with confidence. Contact our licensed insurance brokers for free, personalized guidance, and find the plans that work best for you and your spouse.