Medicare and spouse coverage


Q. My wife and I both work for the Veterans Affairs Department. She has been covered under my self-and-family policy of Blue Cross/Blue Shield for the past 23 years. She will turn 65 this December. I am 59. Is she required to use Medicare for her primary insurer at age 65, or can she continue to use BC/BS as her primary insurer? We are satisfied with BC/BS, and all of our doctors take this easily. Is there a difference between use of Part A (hospitalization) versus Part B? If she chooses not to take Part B at this time, can she use BC/BS for office visits? Can she sign up for Part B later?

A. While no one is required to take Medicare, she will be enrolled automatically in parts A and B when she reaches 65. She can turn down those enrollments if she wants to. However, it makes no sense to turn down Part A. Not only is already paying for it through payroll deductions, but when she retires, the benefits she’s entitled to from her Federal Employees Health Benefits enrollment will be adjusted under the assumption that she has Part A. As for Part B, that’s a personal matter. While she’s working, she can delay a decision about Part B. However, when she retires she’ll have a penalty-free enrollment window. If she declines Part B at that time, and later changes her mind, the premiums will increase by 10 percent for every calendar year she could have been enrolled but wasn’t.


About Author

Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to

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