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Medicare Entitlement for Foreign Spouses

Q. I recently married a Canadian who has applied to become a permanent U.S. resident. Will he be able to get Medicare on my work record and pay the same rate as I pay, or will he have to buy into Medicare?

A. If your work record makes you eligible for full Medicare benefits, then your husband—whatever his nationality—will also be entitled to the same benefits at the same cost, provided he meets all the following conditions:

he is a legal permanent resident of the United States;

he has been married to you for at least one year;

he is age 65 or older.

But for people in other circumstances, the answer could be different.

If you do not qualify for Medicare on your own work record

To be eligible for Medicare at age 65 or older, you need at least 40 Social Security work credits. This generally means about 10 years of work. If you don’t have sufficient credits, your foreign spouse could obtain Medicare only if he or she becomes an American citizen or has lived as a legal resident in the United States for at least five years. Once those conditions are met, your spouse could then buy into Medicare by paying a premium for Part A hospital insurance—which people with enough work credits get for free—and paying the usual premium for Part B, which covers doctor visits and other outpatient services. In 2011, people buying into Medicare pay up to $450 a month for Part A coverage.

If you qualify for Medicare on the work record of a former spouse

Married people with insufficient work credits can become eligible for Medicare on their spouse’s work record, including that of a divorced or deceased spouse. But if you remarry, that may change according to certain circumstances:

If you are a widow or widower who remarries after age 60 (or age 50 if you have disabilities), you remain entitled to Medicare benefits on your deceased spouse’s work record. But a new spouse, whether American or foreign, cannot claim benefits on your former spouse’s record.

If you are divorced and remarry, your marriage ends your entitlement to Medicare benefits on your former spouse’s work record. You can still receive benefits on the new spouse’s work record if he or she has enough work credits—but this would not apply in the case of a foreign spouse who has not worked in the United States.

If you are under age 65 but your foreign spouse is 65 or older

If you already have sufficient work credits to qualify for Medicare at 65, your spouse (whether American or foreign) can become eligible for Medicare on your work record when you reach age 62.

If you are in a same-sex marriage

The information above applies only to spouses of the opposite sex. Under the Defense of Marriage Act, same-sex couples—even if legally married under the laws of their state or their country—are not entitled to Medicare benefits on the basis of their domestic partner’s work record.

Patricia Barry is a senior editor at the AARP Bulletin.