Younger Spouse Losing Health Insurance, Now What?

En español | Q. When I retire at 65, my wife and I will lose our health insurance. I can go on Medicare, but what are the options for my wife, who is younger?

A. The best option for your wife, frankly, is for you to keep working, if at all possible. That way she can continue coverage under your employer plan until she becomes eligible for Medicare at age 65, or, if that day is far off, for at least a few more years.

Many readers ask variations on your question. Some are under the impression that Medicare will automatically cover a younger spouse when they themselves qualify, but it doesn't. There is no family coverage under Medicare. Indeed, nobody can obtain Medicare benefits before age 65, unless eligible because of disability.

Some younger spouses in this situation are able to switch to health insurance provided by their own employers. Some may continue coverage under retiree health benefits provided by their older spouse's former employer. Otherwise, these are the options for a younger spouse not yet eligible for Medicare.

COBRA temporary insurance: The COBRA law allows people who have left or lost a job to continue coverage through their former employer for up to 18 months by paying the full premiums. If eligible, spouses and dependent children can receive this coverage, even if departing employees don't take it themselves. You must apply for COBRA within a certain time frame, so pay attention to deadlines. For more information, see the Department of Labor's guidance on how the COBRA program works.

Is your younger spouse not eligible for health coverage under Medicare? Consider COBRA temporary insurance. — Photo by Creasource/Corbis

Individual insurance: This is insurance you buy on your own. Even though it's called "individual" — to distinguish it from "group" employer insurance — you can purchase a family policy that will cover you, your spouse and any dependent children. This type of insurance is often costly, especially for people older than 50. And if you have a preexisting condition, you may be denied coverage or required to pay a higher premium. To find contact information for insurers that sell policies in your area, go to this government website and click on "Find Insurance Options."

HIPAA-protected insurance: If you've had group or COBRA insurance for at least 18 months — with no break in coverage longer than 63 days — you may have the right under the HIPAA law (the Health Insurance Portability and Accountability Act of 1996) to buy individual insurance that doesn't exclude or limit coverage for preexisting medical conditions. For more information, go to the Department of Labor's guidance on how the HIPAA-protected program works. For specific information on your rights and protections under state law, contact your state department of insurance.

Next: State high-risk health insurance pools. »