Husband's Medicare application delayed but mine approved - will he need gap insurance?

There's a good explanation for this. Medicare enrollment has specific timing windows. You can apply up to 3 months before your birthday month, during your birthday month, or up to 3 months after. The timing determines when your Medicare actually starts. Since you applied in October for February 2025 coverage, and your birthdays are in different months, your coverage start dates might be different based on when you applied relative to your birthday months. Did your husband have his Initial Enrollment Period pass already? If so, he might need to wait for the General Enrollment Period (Jan-Mar) with coverage starting July, which could explain the delay the rep mentioned.

dont worry too much, these things alwyas take longer than they say. my wifes medicare took 2 months longer than mine even tho we applied together. no real reason just SSA being SSA lol. they'll probably backdate his coverage if theres any gap

I went through something similar with my husband last year. The most likely explanation is that your applications got assigned to different processing centers or even different employees within the same center. Some processors just work faster than others. You need to find out EXACTLY when his Medicare will start. If there's even a one-day gap between your employer coverage ending and his Medicare beginning, he ABSOLUTELY needs gap insurance. Hospital stays can cost thousands PER DAY without coverage. Call SSA back and specifically ask when his Medicare coverage will begin. Don't hang up until you get a clear answer. Write it down!

check your myssa online accounts!! thats how i found out i was approved before my husband. sometimes the online status updates before they mail anything. also if you applied "for them to begin" in 2025 like you said theres your problem right there - you cant apply for benefits that far in advance, its usually only 3-4 months max

If anyone is having trouble reaching SSA to get these critical questions answered, I found a service called Claimyr that got me through to an agent in under 5 minutes when I was dealing with a similar Medicare timing issue for my parents. Their website is claimyr.com and they have a video showing how it works: https://youtu.be/Z-BRbJw3puU I was on hold for HOURS trying to figure out my dad's Medicare timing issue until I used this. The peace of mind from getting a straight answer was worth it!

Here's what's likely happening: If you both applied on the same day but have different birth months, your Medicare effective dates would be different based on when you applied relative to your 65th birthdays. An important distinction: - If applying during your Initial Enrollment Period (3 months before your 65th birth month, your birth month, and 3 months after), Medicare starts dates vary based on WHEN in that 7-month window you apply. - If applying during a Special Enrollment Period (like when leaving employer coverage), different rules apply. What you need to do immediately: 1. Confirm if you're in Initial Enrollment Period or Special Enrollment Period 2. Get exact Medicare effective dates for both of you 3. Compare these dates to when your employer coverage ends 4. If there's ANY gap, get Medigap or temporary coverage Don't panic, but do act quickly. If there's a gap, COBRA is an option, though expensive.

i bet its just paperwork got lost or somthing. happens ALL THE TIME with ssa. my benefits were delayed 3 months because they "lost" my birth certificate even tho they scanned it right in front of me!!! make him call again and again til they fix it

Based on your update that you both turned 66 last summer, here's what's happening: You're both past your Initial Enrollment Periods for Medicare (which was around your 65th birthdays). Since you're currently working with employer insurance, you're eligible for a Special Enrollment Period when you retire in January. However, Special Enrollment Period processing can take longer and the rules are slightly different. It's possible your husband's application requires additional verification since he's on your insurance rather than his own. The SSA employee reviewing his application might be waiting for employment verification or other documentation that wasn't needed for yours. I strongly recommend: 1. Call SSA again and specifically ask what documentation is needed to complete his application 2. Ask for the specific expected start date of his Medicare coverage 3. Inquire about temporary COBRA coverage if there will be a gap This is definitely resolvable, but you need more specific information than what you received in that first call.

KEEP COPIES OF EVERYTHING!!!! I learned this the hard way. SSA lost my application TWICE and then tried to charge me penalties because they said I didn't apply on time even though I DID!!! Take pictures of all documents with your phone before you submit them and get names of everyone you talk to. The system is a MESS right now!!!!