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Matt,

 

I’ve heard that if you’re divorced, you’re not eligible for Medicare. Is that correct? What are the scenarios where someone would have to pay for Medicare Part A or Medicare Part B if they’re not entitled to them through marriage, working history or otherwise?  Can you clarify this? Thanks!

Susan P.


Hello Susan,

Having a divorce in your past, in and of itself, does not disqualify you for Medicare. If you’ve been recently divorced, are an immigrant to the United States, or you’re a widow or widower, here are some guidelines for eligibility, which I outline in my book, Prepare for Medicare – The Insider’s Guide

Exceptions for Medicare Eligibility                                

If you’re not entitled or eligible for Original Medicare Parts A and B, you can be deemed eligible for Medicare if you have one of these circumstances:        

  1. If you’re married for at least a year and your spouse is eligible for Social Security benefits when you turn sixty-five.
  2. If you are divorced but were married for ten or more years, you’re covered if your former spouse is eligible for Social Security.                       

Or, if you’re a widow or widower (and currently single) and were married for nine or more months to someone who was eligible for Social Security.            

  1. If you are on Social Security disability for at least twenty-four months or are eligible for receiving retirement benefits from Social Security or the Railroad Retirement Board.

You can also get Part A Medicare if you are a kidney dialysis patient or have received a kidney transplant.

What’s Not Covered Under Original Medicare

Even if you’re eligible for Medicare, there is a list of services that aren’t covered under Medicare Insurance.        

  1. Retail prescription drugs, unless you have coverage under Medicare Part D
  2. Custodial care (help with bathing, dressing, using the bathroom, and eating)
  3. Long-term care (nursing homes, retirement homes, and assisted living facilities)
  4. Cosmetic surgery
  5. Most chiropractic services when not medically necessary
  6. Routine dental and vision services
  7. Most care while traveling outside the United States       

There are many other health-related items Original Medicare A and B do not cover, which insurance companies can provide in certain circumstances. In 2019 and 2020, the Trump administration gave Medicare insurance companies even more flexibility to offer additional benefits to improve in-home care setups and services. It also made changes to allow Medicare insurance companies to allow greater telemedicine and remote-access healthcare for its customers. 

Medicare insurance companies are allowed to include these types of benefits in their Medicare Advantage plans. However, this type of flexibility is not yet being introduced in Original Medicare Parts A and B. This feeds into one of the “Frustrating Flaws” of Medicare, which I cover in Chapter 3 of my book, Prepare for Medicare.

 

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Author Bio Matt Feret is the author of the Prepare for Medicare book series and launched prepareformedicare.com to help people get objective answers to questions about Medicare. Matt is also the host of The Matt Feret Show. He has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development, and strategy for over two decades.