Same-Sex Marriage and Its Impact on Medicare Benefits

By Brian Krantz - April 17, 2023

The landmark Supreme Court decision in Obergefell v. Hodges in 2015 legalized same-sex marriage across the United States. This ruling has had a significant impact on various aspects of life, including access to Medicare benefits for same-sex couples. This article will explore the implications of the Supreme Court’s decision on Medicare eligibility, enrollment, and premium calculations for same-sex spouses.

Medicare Eligibility for Same-Sex Spouses

Prior to the Supreme Court ruling, same-sex couples could only access Medicare benefits based on their individual work history. With the legalization of same-sex marriage, spouses can now qualify for Medicare based on their partner’s work history, just like opposite-sex couples.

  • If your spouse has enough work credits for premium-free Part A, you can qualify for premium-free Part A based on their work history.
  • If your spouse is eligible for premium-free Part A and enrolled in Part B, you can enroll in Part B during their Initial Enrollment Period (IEP) or Special Enrollment Period (SEP) to avoid penalties.

Social Security Administration’s Role in Determining Benefits 

The Social Security Administration (SSA) is responsible for determining Medicare eligibility and premium calculations based on work history. With the recognition of same-sex marriage, the SSA now treats same-sex couples equally when assessing Medicare benefits.

Premium Calculation for Same-Sex Couples

For same-sex couples, Medicare premiums are calculated in the same way as for opposite-sex couples. This includes:

  • Premium-free Part A if either spouse has earned enough work credits.
  • Monthly Part B premiums based on income, with the option to enroll during the IEP or SEP to avoid penalties.

It’s essential for same-sex couples to understand their eligibility and enrollment rights to ensure they receive the full range of benefits available under Medicare.

The recognition of same-sex marriage in the United States has had a profound impact on Medicare benefits for same-sex couples. With equal treatment under the law, same-sex spouses can now access Medicare based on their partner’s work history and receive the same premium calculations as opposite-sex couples. If you need assistance navigating the complex world of Medicare enrollment and benefits for same-sex couples, consider reaching out to a local New York Medicare expert at Plan Medicare or visit for guidance and support.

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