If you are a U.S. citizen age 65 or older, you can get Medicare regardless of your work history — but your costs could vary.
If you’ve paid Medicare taxes for at least 10 years, you can enroll in Medicare Part A and won’t pay a monthly premium .
If you haven’t worked for 10 years and don’t have another qualifying circumstance, you’ll have to pay a premium to get Part A and must sign up for Medicare Part B as well.
You may avoid the Part A premium if your spouse has worked at least 10 years and is at least 62 years old, or if you have a qualifying disease or disability.
No one enjoys paying taxes, but programs like Medicare wouldn’t exist without them.
There’s a clear relationship between the taxes you pay as an employee and the Medicare program that benefits you beginning at age 65, when many people trade in employment for retirement.
If you paid taxes as an employee for at least 10 years, you’re eligible for Medicare Part A health insurance beginning at age 65 without paying a monthly premium for it.
But what if you’ve worked fewer than 10 years as your 65th birthday approaches? What if you haven’t worked at all? Can you get Medicare if you have never worked?
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The Federal Insurance Contributions Acts (FICA) establishes that every working American must contribute 6.2% of their pay to Social Security and 1.45% of their pay to Medicare (amounts that must be matched by your employer).
In exchange, when you turn 65 years old, you are eligible to use Medicare for your health insurance, with any monthly premiums being deducted from your Social Security check (once you are drawing Social Security).
- If you have paid FICA taxes for at least 40 quarters (10 years) through employment, you are eligible for Part A of Original Medicare without having to pay a monthly premium. Part A is commonly referred to as hospital insurance.
- If your income as an individual for 2022 was $103,000 or less (or $206,000 or less on a joint tax return), you are eligible for Part B of Original Medicare for the standard monthly premium of $174.70 in 2024. The income thresholds and monthly premiums change annually (usually by small amounts) for Part B, which is commonly referred to as medical insurance.
You can get Medicare if you worked less than 10 years, but you may have to pay a monthly premium for Part A. If you owe a Part A premium, you will be required to enroll in Part B as well.
The Centers for Medicare & Medicaid Services (CMS) estimates that 99 percent of Medicare beneficiaries don’t have to pay a Part A premium. That’s largely due to most Americans working at least 10 years before age 65, but there also are a few other ways to get Part A without a premium regardless of your work history.
Regardless of your work history, you are eligible for Medicare at age 65 (or younger in some cases) if you’re a U.S. citizen. Your work history comes into play if you want to enroll in Medicare without being responsible for a Part A monthly premium and without being required to enroll in Part B as a condition.
The most common way for people who haven’t worked 10 years to qualify for Medicare Part A without a premium is by claiming the work history of a spouse (or former spouse).
If you don’t have the work history that allows you to enroll in Part A without a monthly premium, your spouse may provide the solution.
While Medicare coverage is always on an individual basis, a spouse can help you qualify. If your spouse — whether it’s a current spouse or a former spouse because of divorce or death — is at least age 62 and has paid Medicare taxes through an employer for at least 10 years, you may qualify for Medicare Part A without a monthly premium.
Note : While your spouse can qualify you at age 62, your spouse still wouldn’t be eligible for Medicare until age 65.
Qualifying Medical Conditions and Disabilities
The Medicare program also offers coverage to you, regardless of work history and age, if you are dealing with certain health challenges.
- If you have been diagnosed with End-Stage Renal Disease, you are eligible for Medicare beginning the first day of the fourth month you receive dialysis.
- If you have been diagnosed with ALS (Amyotrophic Lateral Sclerosis, also known as Lou Gehrig’s disease), you are eligible for Medicare once you begin receiving Social Security Disability Insurance (SSDI).
Social Security Disability (SSDI) Recipients
If you begin drawing SSDI monthly payments for a disability other than Lou Gehrig’s disease, you qualify for Medicare after you receive 24 monthly payments, regardless of work history or age.
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If you want to enroll in Medicare, have worked less than 10 years, and aren’t eligible based on a spouse’s work history or a qualifying disease or disability, then you will have to pay more than most people do to enroll.
- If you have to pay a monthly premium for Medicare Part A, then you also are required to enroll in Medicare Part B. In 2024, the standard monthly premium for Part B is $174.70.
- If you have worked fewer than 30 quarters, the Part A premium for 2024 is $506 a month.
- If you have worked between 30 and 39 quarters, the Part A premium for 2024 is $278 a month.
If you do enroll in Part A and have to pay a premium, you may be eligible in time to reduce or eliminate your monthly premium based on additional work history, or based on your spouse reaching age 62 with a qualifying work history.