Savvy Senior: Health insurance options after a spouse retires


Dear senior expert,

My 63-year-old non-working wife is in my health insurance plan through my employer. When I retire next month and go on Medicare, what are our options for getting her health coverage until she turns 65? Is there some sort of Medicare coverage for dependent spouses?

You need insurance

Dear Need,


Unfortunately, Medicare doesn’t provide family coverage to younger spouses or dependent children when you’re eligible for Medicare. No one can get Medicare benefits before age 65 unless they are ineligible at a younger age due to disability. That said, here are the best options for covering your wife:

Financial Assistance Act: In most cases, the best choice is to get your wife an individual health insurance policy through the Affordable Care Act (ACA) health insurance market (also known as Obamacare). The market offers comprehensive health coverage and you will not be denied coverage or charged extra for pre-existing health conditions.

And thanks to the American Rescue Plan and Inflation Reduction Act, the market is now providing increased benefits through 2025. If your income falls below the 400% poverty level after retiring anything below $73,240 for a couple or $54,360 for a single person in 2023, your wife will be eligible for a tax credit that will reduce the amount you’ll have to pay on her policy. The market also ensures that households with incomes above the 400% poverty level do not have to pay more than 8.5% of their income for a benchmark policy.

To see how much subsidy you might be eligible for, use the Kaiser Family Foundation calculator at

To purchase market plans in your state, visit or call 800-318-2596. Or, if you’d like some extra help, find a market-certified agent or broker at

COBRA: Another option is the Consolidated Omnibus Budget Reconciliation Act (COBRA), which is a federal law that would allow your wife to stay with your company insurance plan for at least 18 months after switching to Medicare. But not all employer plans are eligible for COBRA; contact your employer benefits administrator to find out if yours is one of them.

You also need to be aware that COBRA doesn’t come cheap, requiring you to pay the entire monthly premium yourself. But, if you’ve already met or nearly met your employer’s deductible plans or direct maximum for the year and don’t want your wife to start over with a new plan, or if you feel your employer’s health plan is more affordable than the Marketplace plans, it makes sense for your wife to keep her current coverage under COBRA.


Short-term health insurance: If you can’t find an affordable market plan and COBRA is too expensive, your next option is short-term health insurance. These plans, which aren’t available in all states, are cheaper, essential health plans that provide coverage for one to 12 months and can be renewed for up to three years in some states. But keep in mind that short-term plans aren’t ACA compliant, so they can deny coverage to sick people, don’t cover pre-existing conditions, and can exclude essential elements of coverage like prescription drugs.

To find and compare short-term health plans, try sites like or

Health Care Sharing Ministries: Another coverage option you should know about is Health Care Sharing Ministries (HCSMs). These are cost-sharing health plans in which members who typically share a religious belief make monthly payments to cover the expenses of other members, including themselves.

HCSMs are cheaper than paying upfront for traditional health insurance, but keep in mind that HCSMs are not health insurance. They don’t have to comply with the ACA’s consumer protections. They may also refuse or limit coverage for pre-existing health problems and may limit the amount you will be reimbursed for medical expenses.

To look up HCSM plans, compare the three largest providers:, MyChristianCare.organ, and

Send your senior questions to: Savvy Senior, PO Box 5443, Norman, OK 73070, or Jim Miller is a contributor to NBCTodayshow and author of The Savvy Seniorbook.

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