How to Help Your Spouse Enroll in Medicare

Tamera Jackson by Tamera Jackson | Licensed since 2007
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This article was updated on: 10/16/2017

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If your spouse needs assistance with Medicare enrollment, there are different ways you may be able to help. If your spouse is disabled, you may have authorization such as power of attorney, which will give you the authority to act on his or her behalf. Alternatively, you can help if you and your spouse are both present—for example, if you enroll by phone, and you and your spouse are both on the line—and your spouse verbally indicates that you’re allowed to be present and assist.

Before helping with your spouse’s Medicare enrollment, it’s a good idea to gather as much information as he or she is willing to share about doctors, conditions, medical history, and any prescription drugs he or she is taking. This will provide a better understanding of your spouse’s Medicare needs as you both determine which type of care will fit her needs. It may also be a good idea to encourage your spouse to make an advance directive, which is a statement of his or her wishes regarding medical treatment should he or she become unable to communicate.

Automatic Medicare enrollment

Many Medicare-eligible individuals are enrolled into Original Medicare, Part A (hospital insurance) and Part B (medical insurance) automatically. If this is the case with your spouse, you won’t have to do anything if Original Medicare is all the health-care coverage she or he wants.

  • If your spouse is already getting Social Security or Railroad Retirement Board (RRB) benefits, typically he or she will be automatically enrolled in Original Medicare the month of turning 65, and will get a Welcome to Medicare packet in the mail about three months before his 65th birthday.
  • If your spouse is under 65 and disabled, in most cases she is automatically enrolled into Original Medicare after 24 continuous months of receiving disability benefits from Social Security or certain disability benefits from the RRB. A Welcome to Medicare packet and Medicare card will arrive in the mail three months before the 25th month of disability.
  • If your spouse has Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s disease, he or she will be enrolled in Medicare the same month that the disability benefits begin.

If you’re not sure your spouse meets these requirements, contact Social Security using the information below, or call 1-800-MEDICARE (1-800-633-4227; TTY users call 877-486-2048), 24 hours a day, seven days a week.

Manual Medicare enrollment 

Your spouse will usually need to enroll manually in Medicare if she or he:

  • Isn’t getting Social Security or Railroad Retirement Board benefits (for example, because he or she is still working)
  • Qualifies for Medicare because of end-stage renal disease (ESRD)
  • Lives in Puerto Rico. Residents of Puerto Rico do typically get automatically enrolled in Medicare Part A, but they must sign up for Part B if they want it.

If you do need to assist your spouse with manual enrollment, contact the Social Security Administration. This can be done in person at a local office, online at SocialSecurity.gov, or over the phone at 1-800-772-1213 (TTY users call 1-800-325-0778), Monday through Friday from 7AM to 7PM.

Medicare plan options

Your spouse may have other options aside from or in addition to Original Medicare (Part A and Part B). She or he may be able to sign up for a Medicare plan from a private, Medicare-approved insurance company, such as:

  • Medicare Advantage plan (provides the same benefits as Original Medicare, often with extra benefits such as prescription drug coverage, routine dental and vision care). Hospice benefits are still covered by Medicare Part A when you have a Medicare Advantage plan.
  • Medicare Part D stand-alone Prescription Drug Plan (works alongside Original Medicare)

Another option your spouse might have is to buy a Medicare Supplement plan, which may cover certain Original Medicare out-of-pocket costs such as copayments and deductibles). Medicare Supplement plans are available from private insurance companies, and are designed to work alongside your Medicare Part A and Part B coverage.

Be aware that each of the plan types described above has eligibility requirements. Also, your spouse still needs to continue to pay the Medicare Part B premium even after enrolling in a Medicare health plan.

There are certain enrollment periods throughout the year where you and your spouse can enroll in, change, or drop Medicare Advantage and Medicare Part D Prescription Drug Plans. A common time to sign up for a Medicare Advantage or Prescription Drug Plan is during the Annual Election Period (AEP), which runs from October 15 to December 7 each year.

Would you like to talk with me about Medicare plan options? I’d love to talk with both of you, but if your spouse can’t be on the phone, I can still answer any general questions you might have about Medicare coverage options. I’d be happy to set up a telephone call with you, or send you information about Medicare plan options; just follow the links below to make that happen. You may prefer to explore plan options on your own; to do this, just click the Find Plans button or, you’re welcome to call us anytime during our business hours at 1-844-847-2660, or 711 if you’re a TTY user. Representatives are available 8AM-8PM ET Monday through Friday.

The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

The purpose of this communication is the solicitation of insurance.  Contact will be made by an insurance agent/producer or insurance company.

Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare program.

The product and service descriptions, if any, provided on these Medicare.com Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

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