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What happens to my dependents when I go on Medicare?

You might be asking yourself, what happens to my dependents when I go on Medicare? Enrolling in Medicare changes your health insurance. And it can also impact your Medicare dependents insurance. Medicare coverage isn't available for dependents. So, anyone who needs health insurance will need to secure different coverage. At the age of retirement, your dependents may include a younger spouse or child under the age of 26.

Fortunately, there are many medical insurance options to consider. Your family needs to thinks about their needs so they avoid losing coverage.

What happens when one spouse goes on Medicare?

Once one spouse enrolls in Medicare, the other spouse or dependents will need to enroll in a new insurance plan. The spouse not on Medicare should make the start date match the end date of the current coverage. If you suddenly lose coverage, your dependents can get new coverage the next day, but guidelines may vary by state and specific situation.

Know when a spouse or dependents should enroll in health insurance.

Dependents of someone about to enroll in Medicare can enroll in their own plan up to 60 days before they lose coverage. Before then, take time to explore the possibilities. “Give yourself enough time to do the research you need to make a decision,” says Sandra Troia, director of telesales and channel operations at Highmark. “That way your family can make an informed decision.”

Does Medicare cover dependents?

The short answer is no. However, before you do any research to find them a new plan, take time to look at your dependent’s budget and needs. “The big first step is to figure out your dependent’s income,” says Mike Pelino, Highmark’s manager of segment strategy and analytics. If you are retiring, consider what your dependent’s expected income will be after you retire. “Your budget defines what they're comfortable paying as a premium, or monthly payment.”

According to Pelino, your family's retirement income also determines if your dependents will qualify for government help. If your dependent is under 19 years of age, consider the Children’s Health Insurance Program (CHIP), a joint federal and state program. So, before you ask yourself, “does Medicare cover dependents”, find out if your uninsured child can get health coverage through CHIP. They’ll usually qualify if your family’s income is too high to qualify for Medicaid and too low to afford private insurance.

Other details to consider for your dependent include:

  • How long they will need coverage.
  • The type of coverage they will need.

For example, a young adult needs insurance for years to come, while a spouse may only need coverage for a couple of years. “And sometimes a spouse’s employer offers an early retirement plan,” Pelino says. “If not, there are other options. It’s all dependent on your family’s personal preference and situation.”

Understand COBRA health insurance

One insurance option that all dependents should consider is coverage through COBRA. With COBRA, after an employee retires, most group health plans provide temporary coverage for spouses and dependent children. The longest period of coverage is 36 months from the date that your Medicare begins.

Keep in mind that COBRA leaves your dependent responsible for the full cost of the coverage. But that expense may be worth it for the short-term. It’s best to compare options and then establish a budget.

Explore individual health insurance plans

For many dependents, an individual health plan makes the most sense. “There are many options available so your dependent can find a plan that's cost friendly with a great network,” Pelino says. But wading through the possibilities may be daunting.

To help your family find the best plans for your situation. If you are in Delaware or West Virginia, Pelino recommends visiting Highmark.HealthSherpa.com. This online tool shows opportunities where dependent can save and compare available plans. You can also enroll your dependents through this site. If you are in Pennsylvania, visit Highmark’s Affordable ACA Plans page.

Consult with a health insurance agent

No matter how much research you do, there are many benefits of using a licensed insurance agent. Agents bring expertise, identify government programs, and offer convenient ways to connect. “You can work with a licensed insurance agent over the phone or in person” Severin says. “It’s your choice to pick a plan option that works best for your family.”

If you live in Pennsylvania, you can meet with an ACA individual and family plan advisor over the phone or in person at a Highmark Direct Health Insurance Store. In New York, you can also meet in-person at one of our Highmark Medicare Centers. Before connecting with a health insurance agent, your dependent should gather important information, including:

  • Preferred providers
  • Current prescriptions
  • Financial information, including expected income and budget for health care

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Learn more about insurance coverage for dependents

Find out more about the coverage options available for loved ones. Choosing what you're comfortable spending can help you narrow your options.