When to Enroll in Medicare if You’re In a Nontraditional Marriage

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So this question arises: If you’re the covered partner (as opposed to the partner whose employer provides the benefits), can you delay Part B enrollment if your other half is still working?

Consider two scenarios: if you’re legally married to someone of the same sex or if you live together as an unmarried couple in a domestic partnership with somebody of the same or opposite sex. In many situations such as these, one partner gets health insurance under the other partner’s employer benefits.

Enroll in Medicare when you’re in a same-sex marriage

Since the U.S. Supreme Court struck down part of the Defense of Marriage Act (DOMA) in June 2013, the term spouse is no longer narrowly defined as a person married to someone of the opposite sex when it comes to eligibility for federal benefits.

However, at the time of writing, the Social Security Administration is still working on new guidelines; so how the court’s ruling applies, especially to same-sex spouses living in states that don’t permit same-sex marriage or recognize the marriage laws of states that do, isn’t yet clear. For updates, call Social Security at the number listed earlier or go to its website and use its search engine to look up “DOMA.”

One rule already in existence before the downfall of DOMA may guarantee your right to delay Part B and get a SEP if you’re covered as a “family member” on your spouse’s employer insurance — but only if you’re under age 65 and have Medicare based on disability. Because this rule also applies to people in domestic partnerships.

Enroll in Medicare when you’re in a domestic partnership

Domestic partnership means an arrangement in which you’re living as a couple with a person of the same or opposite sex but are not formally married. In general, you’re not permitted to delay Part B in this situation without incurring late penalties on the basis of receiving health coverage from your partner’s employer plan. But some exceptions do exist:

  • Medicare allows you to delay Part B after age 65 and have a special enrollment period to sign up without penalty when your partner stops work or loses employer health benefits, as long as both of the following are true:

    • Your domestic partner is the opposite sex.

    • You live together in one of the states that accept common-law marriages and your domestic partnership meets the legal definition of common-law marriage where you live.

  • You’re allowed the same exception if all the following are true:

    • You’re under age 65 and have Medicare because of disability.

    • Your partner’s employer has 100 or more employees.

    • You’re accepted on your partner’s employer insurance as a “family member” — even if you aren’t legally married to the employee and regardless of whether he or she is the same or opposite sex to you.

  • You’re also allowed the same exception if all the following are true:

    • You’re 65 or older, or you’re younger but have Medicare due to disability.

    • Your initial enrollment period began December 2004 or earlier.

    • You declined Part B during that IEP or voluntarily opted out of Part B coverage that you’d had before December 2004.

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