Can You Get Medicare if You've Never Worked?
Key Takeaways
- 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 AMedicare Part A is hospital insurance, which covers the care you receive while admitted to a hospital, skilled nursing facility, or other inpatient facility. Medicare Part A is part of Original Medicare. and won’t pay a monthly premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. .
- 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 BMedicare Part B is medical insurance that covers Medicare-approved services — such as medically necessary treatment and preventive services — and certain other costs, like durable medical equipment. Medicare Part B is part of Original Medicare. 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.
Can you get Medicare if you never worked? The answer is yes, you can still enroll in Medicare if you have never worked or worked for fewer than 10 years. But your Medicare coverage may cost more because you have not paid enough taxes into the program.
No one enjoys paying taxes, but programs like Medicare wouldn’t exist without them. Most people qualify for premium-free Part A Medicare benefits once they reach age 65 because the taxes they paid through working contributed to their Medicare coverage. However, you can still get Medicare if you’ve never worked by paying for your Part A coverage.
In some cases, you may still qualify for premium-free Part A benefits through your spouse or if you have a qualifying medical condition or disability. Read on to unlock Medicare benefits, even if you’ve never worked.
Can You Get Medicare if You Never Paid Social Security?
Working Americans pay a portion of their earnings toward social security taxes, which include Medicare benefits. Specifically, employees are taxed according to the Federal Insurance Contributions Act. Most people qualify for premium-free Part A benefits because they meet the minimum contribution of at least 40 quarters, which equals 10 years of employment and paying taxes.
When seniors become eligible for Medicare at 65, most have met the minimum work history requirements to earn premium-free Part A benefits. In 2024, 99% of Medicare enrollees received premium-free Part A benefits because they paid adequate social security taxes. The remaining 1% may still qualify for premium-free Part A through their spouse, or they can pay a premium for Medicare Part A benefits.
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Medicare Eligibility for People Who Never Worked
You do not need to have worked to be eligible for Medicare altogether; meeting the work history requirement is merely a criteria for receiving premium-free Part A benefits. If you have never worked, you may meet alternate criteria, either through your spouse or a qualifying medical condition or disability, to receive premium-free Part A.
Generally, people who have never worked will not be automatically enrolled in Medicare but can sign up for Part A and Part B benefits as early as three months before and up to three months after their 65th birthday month. For example, if you turn 65 in July, you can enroll in Medicare as early as April and as late as October.
How Much Medicare Costs If You’ve Never Worked
Medicare Part A and Part B, also called Original Medicare, cover inpatient and outpatient healthcare, respectively. Each part has its own monthly premium amount:
- If you have never worked or have worked fewer than 30 quarters by your 65th birthday, Medicare Part A would cost $518 per month in 2025.
- If you worked between 30-39 quarters, Medicare Part A would cost $285 per month in 2025.
- Medicare Part B is not dependent on how much you have worked. The 2025 premium for Part B is $185 per month, but those whose modified adjusted gross income exceeds $106,000 pay more.
However, you may still be eligible for premium-free Medicare Part A if you never worked. Explore some of your options below.
Get Premium-Free Part A From Your Spouse
Generally, you may qualify for premium-free Part A benefits if your spouse has worked for at least 40 quarters (10 years). Your spouse must be eligible for retirement or social security benefits and you must have been married for at least one year.
You may also qualify for premium-free Part A if you have never worked and are divorced or widowed as long as meet the following criteria:
- Your former spouse was eligible for retirement or social security benefits
- You were married for at least 10 years before divorcing or at least nine months before your spouse passed away
- You are currently single
If you remarry, your new spouse must meet the general qualifications for you to receive premium-free Part A benefits.
Medical Qualifications for Premium-Free Part A
Even if you have never worked, you may still qualify for premium-free Part A benefits through medical criteria:
- You receive Social Security Disability Insurance (SSDI). Those who receive SSDI will be automatically enrolled in Medicare on the 25th day of the 24th month even if you are under 65.
- You have end-stage renal disease (ESRD). Those with ESRD and have undergone a kidney transplant or are on dialysis must be eligible for Social Security benefits or Railroad Retirement Board benefits. Or, your spouse or parent must be eligible for Social Security benefits if you are under 65.
- You have ALS (Lou Gehrig’s Disease). Beneficiaries diagnosed with ALS are automatically eligible for premium-free Part A Medicare benefits.
Can You Get Medicare if You’ve Worked Less Than 10 Years?
If you are still employed but have not worked enough to qualify for premium-free Part A, you can pay for Part A until you have accrued enough work time to be eligible for premium-free benefits.
- If you have worked 0-30 quarters, Medicare Part A costs $518 per month in 2025.
- If you worked between 31-39 quarters, Medicare Part A costs $285 per month in 2025.
- Once you have worked 40 quarters, you are eligible for premium-free Part A.
If you retire before working 40 quarters and do not meet other eligibility for premium-free Part A, you will pay for Medicare Part A coverage.
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Don’t Delay Medicare Enrollment
The best time to enroll in Medicare is during the Initial Enrollment Period (IEP), which begins three months before your 65th birthday month and ends three months after. You may incur a late enrollment penalty if you enroll outside of your IEP unless you qualify for a Special Enrollment Period.
While it can be tempting to delay enrollment to avoid paying for Part A and B, you’ll incur late penalties and a lapse in coverage if you do not have alternative coverage through your employer or spouse.
Medicare Has Late Enrollment Penalties
Late enrollment in Medicare may come with temporary or permanent penalties. If you miss your Initial Enrollment Period to sign up for Part B, you may pay a one-time late fee if you enroll during the next General Enrollment Period. However, failing to do this incurs a permanent penalty, meaning you’ll pay a late fee as long as you have Medicare.
| Medicare Part | Penalty | Duration | Example |
|---|---|---|---|
| Part A | Monthly premium increases 10% | Twice the number of years you delayed enrollment | If you were eligible since 2025 but did not enroll in Part A until 2027 (two years later), then you will pay the higher premium for four years. |
| Part B | 10% penalty for every year you delay enrollment | Permanent | If you were eligible since 2025 but did not enroll in Part B until 2027 (two years later), then you will pay a 20% late ernollment penalty on top of your standard Part B premium for as long as you have Medicare. |
| Part D | 1% penalty for every month you delay enrollment | Permanent | If you were eligible since June 2025 but did not enroll in Part B until May 2027 (23 months later), then you will pay a 23% late ernollment penalty on top of your standard Part D premium for as long as you have Medicare Part D. |
Going Without Insurance Can Be Costly
Even if you’re relatively healthy now, health concerns can become more serious and costly with age. For example, a fall can be much more catastrophic for seniors than for young adults.
The average cost of treatment for a fall was $62,521 in 2023, according to a study reported in the National Library of Medicine. Suffering an illness or injury without health insurance can be even more devastating. According to KFF.org, 62% of uninsured adults reported having healthcare debt, compared to 44% of insured adults who did not.
Marketplace Health Insurance Can Become Too Expensive
You may be able to decline Medicare coverage and purchase an Affordable Care Act (ACA) plan through the Healthcare Marketplace, but only if you do not qualify for premium-free Part A or are not collecting Social Security benefits.
While you may be looking to save on premium payments, ACA plans are often the same or even more expensive than Medicare, especially as you get older. For example, ACA plans cost an average of $544 for a 40-year-old and $760 for a 50-year-old in 2025.
Exceptions to Delaying Enrollment
There are some exceptions to delaying your Medicare enrollment. You can delay enrolling in Part A and Part B without penalty if you still have employer coverage or coverage through your spouse.
For example, if you have employer-based coverage comparable to Medicare, you may be eligible to delay enrolling in Medicare without paying a late penalty. You may also qualify for a Special Enrollment Period following the loss of your employer-based coverage to enroll in Medicare.
Other Medicare Options If You’ve Never Worked
As long as you meet the requirements for Original Medicare, you also qualify for the following:
- Medicare Advantage: Medicare Advantage plans cover the same things as Original Medicare at minimum. Many offer benefits not covered through Original Medicare. For example, Medicare Advantage Prescription Drug Plans include prescription drug coverage. Medicare Advantage is offered through private insurance providers and replaces your Original Medicare benefits.
- Medicare Part D: Part D offers standalone prescription drug coverage to beneficiaries enrolled in Original Medicare or a Medicare Advantage plan that lacks prescription coverage. These plans are offered through private insurance providers.
- Medicare Supplement: Also called Medigap, Medicare Supplement plans provide financial support for out-of-pocket Medicare costs like deductibles and copays. In all but three states, these plans offer standardized benefits. Beneficiaries under 65 who qualify for Medicare may have more limited Medigap plan options until they turn 65. Medigap is only available to those with Original Medicare.
Putting It All Together
You can still get Medicare if you have never worked. The difference is that you may need to pay for Medicare Part A whereas most beneficiaries qualify for premium-free Part A because they’ve met work requirements. Beneficiaries may also be eligible for premium-free Part A through their spouse or if they have a qualifying condition or disability such as ESRD, SSDI, or ALS.
Can I avoid paying a Part A premium at age 65 by not enrolling?
If you don’t sign up for Part A at age 65 because you don’t want to pay the premium, but you plan to enroll in the future, delaying enrollment could result in a late enrollment penalty. For every year you delay enrollment, you will have to pay a 10% penalty for two years. So if you owe a Part A premium because you haven’t worked for at least 10 years and you first enroll at age 68, you will have to pay a 30% penalty for six years.
There is a scenario, however, where delaying enrollment could save you from paying a Part A premium.
Let’s say at age 65 you don’t qualify for Part A without a premium, but come age 68, you will qualify — either because you worked for three more years and have now worked 10 years or because your spouse has worked 10 years and is turning 62. Either way, you now qualify for Part A without a premium and therefore won’t have to pay a late enrollment penalty.
Can you get Medicare Advantage if you've worked less than 10 years ?
With Original Medicare or Medicare Advantage, you’re still responsible for premiums that you have to pay based on your limited work history. A Medicare Advantage plan, however, could help your bottom line in a couple of ways.
Medicare Advantage plans are offered by private insurance companies under the guidance of the federal Medicare program. They provide an alternative to Original Medicare, offering the same coverages provided by Parts A and B, and more. Medicare Advantage plans can offer things that Original Medicare can’t — like dental coverage for example — that may save you money.
Some Medicare Advantage plans have a monthly premium. When you switch, you are still responsible for any Part A and B premiums that you owe. But most Americans have access to a Medicare Advantage plan with a $0 premium, and some Medicare Advantage plans help pay your Part B premium.
A GoHealth licensed insurance agent can help you determine if a Medicare Advantage plan would be beneficial for you and your finances.