The loss of a spouse may be accompanied by a loss of health care coverage. Having a gap in coverage for even a single day can be devastating to you and your dependents.

If you are eligible for Medicare, no gap in coverage will occur (unless you fail to timely apply for coverage). However, you could experience a gap in full coverage if your supplemental “Medigap” coverage (see below) lapses.

If you are not at least 65 years of age and thus not eligible for Medicare, one of the first orders of business after your spouse’s death is to secure medical insurance.

You can secure private health insurance from any number of private health insurance carriers, or from your late spouse’s employer, if you are eligible for “COBRA” coverage.

COBRA COVERAGE

If at the time of your late spouse’s death, he was employed by a company with at least twenty full-time employees, you may be eligible to continue his hospitalization and major medical insurance. The right to continuation coverage was created under the Consolidated Omnibus Budget Reconciliation Act, and is commonly known as “COBRA coverage.”

The coverage is identical to the coverage offered while your spouse was alive. The maximum period that you may continue your late spouse’s coverage is 36 months. Both you and your dependent children are eligible.

COBRA coverage is not free; you must pay your late spouse’s employer 102% of its cost for carrying you. The company’s employee benefits department should be able to provide specific information as to the coverage available as well as premium cost.

COBRA coverage will likely be cheaper and more comprehensive than coverage you can find on your own, especially if you or a member of your family has serious health problems.

MEDIGAP COVERAGE

If you are eligible for Medicare (age 65+) you should purchase Medicare supplement (“Medigap”) insurance to cover medical costs not covered by Medicare. The most significant gaps in Medicare are deductibles, co-payments, and non-covered charges.

Adding Medigap coverage assures nearly complete hospitalization and major medical coverage and is therefore recommended.

Since Medicare only covers prescription costs associated with a hospital stay, you should also purchase the Medigap prescription option. Medigap can be purchased from many major medical insurance companies.

You might consider using the plans suggested by AARP as a way to compare various Medigap policies. Call the AARP Health Care Options toll free number at 1 (800) 245-1212, ext. 99.

Part A of Medicare generally provides reimbursement for hospitalization and miscellaneous services and supplies, plus home health care and limited skilled nursing care. Part B of Medicare covers for doctors’ services, medical services, and supplies. The charts below summarize the major provisions of Medicare Parts A and B.
 

Medicare Part A is financed through the 1.45% tax on all earned income, with an employer matching amount equal to the employee’s tax.

Note: You must also pay for any charges in excess of the Medicare-approved amount.

Medicare Part B is financed through monthly premiums of $50 per person, deducted from your Social Security check.

Important: see the discussion of Medicare in Chapter Three “Navigating Social Security” for more a detailed discussion of Medicare