How Medicare is affected by the overturn of the Defense of Marriage Act (DOMA)

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In light of the Supreme Court’s ruling that parts of DOMA are not legal, there will be changes to Medicare and Social Security rules for same-sex spouses. This means parts of your Social Security and/or Medicare may change. These changes could include the following:

  • You may qualify for free Part A  based on your spouse’s working history.
  • You may qualify for Social Security Retirement benefits based on your spouse’s working history.
  • You may qualify for ESRD-Medicare based on your spouse’s working history.
  • You may qualify to use your spouse’s group health plan coverage as primary coverage to Medicare, even after you turn 65. This means you may be able to delay Part B enrollment while your spouse is still actively working and for up to 8 months after they stop working without penalty.
  • You may qualify for a reduction, or roll-back, of a late enrollment penalty you already have if you were covered by insurance provided by your spouse’s current employer at the time you delayed Part B.
  • There may be changes to your Part B premiums.
  • There may be changes to your Part D premiums.
  • There may be changes to your eligibility for Extra Help

For some of the benefits listed above, you will only be eligible if you were married in a state that performs same-sex marriages after that state legalized same-sex marriage and you currently live in a state that performs same-sex marriages. For a list of states that approve and recognize same-sex marriage, and the applicable dates, see this rule from the Social Security Administration.

All legally married people, regardless of where you live, can:

  • Delay Medicare Part B enrollment without penalty while you are covered by insurance from your own or your spouse’s current employer 
  • Enroll in Medicare Part B at any time while covered by insurance from your own or your spouse’s current work, and for 8 months after that coverage ends.
  • Have premium penalties for late enrollment removed or rolled back if you delayed enrollment into Part B because you were covered by insurance from your spouse’s work before you enrolled in Medicare.

Updates to these rules and new instructions are still being released. Social Security has grouped same-sex marriage related questions on SocialSecurity.gov, which can be found here. Medicare.gov has a similar page which can be found here.

For general information on the Defense of Marriage Act, and the Windsor decision, please see the Frequently Asked Question page on the Gay & Lesbian Alliance Against Defamation (GLAAD) website. For specific information on how overturning DOMA will affect older Americans, please visit the information and resources page on the Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) website. This page includes resources for further reading from AARP and other advocates.

If you need assistance understanding how your Medicare or retirement benefits will work now that parts of DOMA have been overturned, please contact the Social Security Administration (800-772-1213). Remember, ask for the name of the representative you speak to and get all answers in writing before making any changes to your coverage. 


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