How Medicare is affected by marriage equality

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In light of the Supreme Court’s rulings that the Defense of Marriage Act was not legal and that same-sex marriages must be issued and honored by all states, 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 can qualify for free Part A  based on your spouse’s working history.
  • You can qualify for Social Security Retirement benefits based on your spouse’s working history.
  • You can qualify for ESRD-Medicare based on your spouse’s working history.
  • You may be able to use your spouse’s group health plan coverage as primary coverage to Medicare, even after you become eligible for Medicare. This means you may be able to delay Part B enrollment.
  • You can delay Medicare Part B enrollment without penalty while you are covered by insurance from your spouse’s current employer. 
  • You can enroll in Medicare Part B at any time while covered by insurance from your spouse’s current work, and for 8 months after that coverage or work ends, without penalty.
  • You can 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.
  • 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, the date and location of your marriage may matter. For a list of states that approve and recognize same-sex marriage, and the applicable dates, see this rule from the Social Security Administration.

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

For information about other benefits, 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, 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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