Health Insurance For Spouse Or Child When Joining Medicare
How to Find Health Insurance for Your Spouse or Child When Joining Medicare
Enrolling in Medicare changes your health insurance, but it also impacts the dependents on your plan, like your spouse and children. If Medicare isn’t an option for your loved ones, they’ll need to find new coverage by the time you enroll.
Fortunately, there are plenty of options for dependents. By preparing ahead of time, they can avoid a lapse in coverage. Below, check out some key steps to help them find a great plan.
Know your deadlines
Your dependents can enroll in an individual or family plan up to 60 days prior to losing coverage. Before then, take time to explore plan options.
Once your dependent enrolls in a new plan, they should set the effective date to match the end date of the current coverage. If you lose coverage unexpectedly, your dependent’s new insurance can kick in the next day (or even retroactively), depending on your location and circumstance.
Work within your budget and timeline
“The big first step is to assess your dependent’s income and budget,” says Mike Pelino, Highmark’s director of market strategy and analytics. “If you’re retiring, be sure to consider your dependent’s expected income after you retire, instead of your current combined income.”
According to Pelino, your family income after retirement also determines whether your dependent will qualify for government premium subsidies, assistance, or programs. If your dependent is under 19 years old, consider the Children’s Health Insurance Program (CHIP), a joint federal and state program. Your child may be eligible for CHIP if your family’s income is too high to qualify for Medicaid and too low to afford private insurance.
You should also consider the length of coverage and type of plan. A young adult will need insurance for years to come, while your spouse might only need it for a couple more years. “Sometimes a spouse’s employer offers an early retirement benefit plan, which is an easy solution,” Pelino says.
Research individual insurance plans
For many dependents, an individual health plan makes the most sense. “There are many options available, so your dependent can find the best plan in terms of cost and network,” Pelino says.
This tool can help your dependent find an affordable plan with the right features — and they can enroll on our website.
Understand COBRA insurance
One insurance option that all dependents should consider is coverage through the Consolidated Omnibus Budget Reconciliation Act (COBRA). Most COBRA plans offer temporary continuation of coverage for spouses and children after an employee retires. The maximum period of coverage is 36 months from the date that your Medicare coverage begins.
Keep in mind, COBRA leaves your dependent responsible for the full cost of the coverage. However, that expense may be a better option for short-term insurance.
Consult with an advisor
Even if you’re doing your own research, a licensed insurance advisor is a great asset. Advisors bring expertise, identify possible government assistance, and offer convenient ways to connect.
Before meeting with an advisor, your dependents should gather the following information:
Financial information, including expected income and budget for health care.
We’re here to help
To learn more about finding a plan for your dependents, schedule a personal consultation with a licensed Highmark insurance advisor by visiting our Medicare reservations page.
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.
This website is operated by Highmark, Inc. and is not the Health Insurance Marketplace website. It also does not display all Qualified Health Plans available through the Health Insurance Marketplace website. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace website at HealthCare.gov.
Highmark Blue Cross Blue Shield or Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal.
®Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company.
PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418.
Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield.
West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit our website to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card.
Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield.
Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
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