Q: I’m in a same-sex marriage and will soon be 65. How does my marital status affect my eligibility for Medicare?
A: Since the Supreme Court’s historic ruling on June 26, 2015 made same-sex marriage legal throughout the United States, you now have the same rights under Medicare as any other married couple.
This is a complete reversal of the laws that were in place only a short time ago. Until June 2013, the federal Defense of Marriage Act (DOMA) defined the word “spouse” as a man or woman who was legally married to a person of the opposite sex, thus excluding same-sex spouses from thousands of federal benefits. In that month, the Supreme Court struck down parts of DOMA as unconstitutional. The practical effect of this ruling was that same-sex spouses became entitled to federal benefits if they lived in a state that recognized same-sex marriage — but not if they lived in states that didn’t provide such recognition.
The court’s 2015 ruling, however, puts all married couples on the same legal footing in claiming benefits, anywhere in the United States and its territories. So, to be clear, if you’re in a same-sex marriage, here’s a quick primer of your rights under Medicare:
Becoming eligible for Medicare on your spouse's work record
At age 65 and older, you can get Medicare Part A benefits (mainly coverage for hospital stays) without paying monthly premiums for them if you’ve earned 40 work credits by paying payroll taxes on your earnings (usually equivalent to about 10 years of work.) If you haven’t earned 40 credits, you can qualify for premium-free Part A on the work record of your spouse, if he or she has achieved the required credits and is age 62 or older.
If neither of you has 40 credits, you can still receive Part A benefits by paying monthly premiums. No work credits are necessary to qualify for Part B (which covers doctors’ services, outpatient care and medical equipment) or for Part D (prescription drug coverage) — you just pay the required premiums, same as anybody else, provided that you’re either a U.S. citizen or a permanent legal resident (green card holder) who has lived in the United States for at least five years. (The five-year residency is waived if you’re a green card holder who has been married for at least one year to a U.S. citizen or another legal resident who is at least age 62 and has 40 work credits.)