The award was presented in a special Capitol Hill ceremony attended by members of both Democrat and Republican parties. President George W. Bush was the keynote speaker.
"This is very, obviously, very special occasion for me, and very memorable, because it was in this room that Ronnie and I cam after his inaugural," Nancy Reagan said. "And it was in this room that we found -- we were told that the prisoner's (U.S. hostages) had been released, and they were in Iranian airspace, and everything was going to be all right.
"But I want to thank you, all of you ...I can't say any more. Thank you very much."
President Bush described the former president as one of the largest figures of our time.
"His name will always stand for courage and consistency, for patriotism and resolve, and for humor and optimism," Bush said. "President Reagan believed deeply in American character and destiny."
Reagan, who suffers from Alzheimer's disease, was not present at the ceremony to receive the medal, which was approved by Congress in July 2000. He is only the third president since the onset of the 20th century to receive the award.
"He believed deeply in the power of freedom to improve the lives of average men and women," Bush said. "These ideas changed America, and they changed the world. Not only because he eloquently explained them, because they are right and true"
Reagan, who was known as the "Great Communicator," was credited with leading Americans into a new pride of country and accomplishment after the hand-wringing angst that followed the Vietnam War. He is also credited with helping bring about the collapse of communism in Eastern Europe.
"At every step of an amazing life, Nancy Reagan has been at Ronald Reagan's side," Bush said. "As his optimism inspired us, her love and devotion strengthened him.
"As first lady of California (where Reagan had once served as governor) Mrs. Reagan spoke out on behalf of POWs and American servicemen missing in action. As our first lady of the United States, Nancy Reagan led an anti-drug campaign that helped significantly reduce teen drug use. Now she has joined the fight against the terrible curse of Alzheimer's."
The Gold Medal's first recipient was Gen. George Washington, who was awarded the honor by the Continental Congress in 1776. Since then, its roll call of recipients has included the likes of naval hero John Paul Jones (1787), Maj. Gen. Ulysses S. Grant (1863), inventor Thomas Edison (1928) and Charles Lindbergh (1928), actor Danny Thomas (1983) and groups such as the Navajo Code Talkers of World War II (2000).