How to Find Health Insurance for Your Spouse or Child When Joining Medicare

photo of a man and women on their couch talking on the phone

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.

To help your family navigate their choices, you can use Highmark’s plan comparison tool on our Individual and Family Plans resource page.

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:

  • Preferred providers.
  • Current prescriptions.
  • 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.