Many workplace health plans do offer coverage for an employee’s domestic partner. And some domestic partners assume that, like legally married people, they don’t need to enroll in Medicare Part B when they turn 65, as long as they remain on their partner’s plan.
That is not so. Medicare does not offer domestic partners the same benefit rights as legal spouses.
Legal spouses’ rights include a special enrollment period, or SEP, for Medicare Part B, which primarily covers doctors’ services and outpatient care. Legal spouses who become eligible for Medicare can delay signing up, without risking a late penalty, if they have insurance through their mate’s job. When your spouse’s employment ends and you lose that coverage, you have an eight-month grace period to enroll in Part B with no penalty.
If domestic partners in the same situation delay signing up, they are not entitled to that special enrollment period and will pay penalties for Part B, in the form of permanently higher premiums.
Medicare officials will measure the late period from when you first became eligible. The longer that gap, the bigger the penalty.
Domestic partners might qualify for a special enrollment period and avoid late charges only for these two narrow exceptions:
Common-law marriage. If you and your partner live in a state that recognizes common-law marriages and your relationship meets the legal definition of common-law marriage in that state, Medicare will consider you spouses and apply the spousal rules.
Disability. People who receive Social Security Disability Insurance (SSDI) can qualify for Medicare before age 65. Domestic partners with a disability may be allowed a special enrollment period if they meet all these conditions:
- They are younger than 65 and entitled to Medicare based on their disability.
- They are covered under their partner’s workplace insurance.
- That workplace employs at least 100 people.
For eligibility based on disability, you get a special enrollment period if you received coverage from what Medicare considers a large group health plan via your employer or that of a "family memger." Domestic partners don’t meet Medicare’s definition of a spouse, but they do count as family members for SEP purposes.
But remember that once you hit 65, your Medicare eligibility is based solely on age. The disability exceptions become irrelevant. At that point, if you don’t sign up for Part B — or marry your partner — you’ll likely face those late enrollment charges down the road.