Can You Get Medicare If You Never Worked?
Medicare is available to people who are 65 years old or older, regardless of their work history. However, if you have not worked and paid Medicare taxes for at least 10 years, you may have to pay higher premiums for Part A and Part B.
- Written by Terry Turner
Senior Financial Writer and Financial Wellness Facilitator
Terry Turner has more than 35 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).Read More
- Edited ByLamia Chowdhury
Lamia Chowdhury is a financial content editor for RetireGuide and has over three years of marketing experience in the finance industry. She has written copy for both digital and print pieces ranging from blogs, radio scripts and search ads to billboards, brochures, mailers and more.Read More
- Reviewed ByChristian Worstell
Christian Worstell is a licensed health insurance agent and an established writer in the sector, with articles featured in Forbes, MarketWatch, WebMD and more. His work has positively impacted beneficiaries nationwide and empowers them to make strong health care decisions.Read More
- Published: September 9, 2021
- Updated: October 20, 2023
- 7 min read time
- This page features 11 Cited Research Articles
- Edited By
- Even if you have never worked, you can still get Medicare, but it may cost you more.
- If you have worked and paid Medicare taxes for less than 10 years, you will have to pay premiums for Medicare Part A coverage, unless your spouse meets Medicare work requirements.
- If you are or were married to a spouse who is or was eligible for Medicare benefits, you may be eligible for Medicare even if you haven’t worked.
- If you have Lou Gehrig’s disease or end-stage renal disease, you may also be eligible for Medicare even if you haven’t worked or are not yet 65 years old.
Medicare Coverage for People Who Never Worked
Your Medicare Part A coverage is essentially paid for while in the workforce since you pay taxes for Medicare while employed. If you never worked, you will not be eligible for premium-free Part A unless your spouse meets the work requirements or you have a qualifying disability. Part A covers inpatient care and hospital stays.
You can still get premium-free Part A without any work history as long as your spouse has worked and paid Medicare taxes for at least 40 quarters (10 years) or you have a qualifying disability. Otherwise, you’ll have to pay a monthly premium like any other form of insurance. That premium could be reduced if you spent some time in the workforce.
For example, if you were employed for years but put your career on pause to be a stay-at-home parent or for any other reason, you could be eligible for a reduced premium.
If you or your spouse never worked, then your Part A premium for 2024 will be $505. But if you or your spouse spent at least 30 to 39 quarters in the workforce and paid Medicare taxes, your premium could be reduced to $278.
Medicare Part B, which covers outpatient care, comes with a monthly premium that is not affected by your work history.
There are additional ways to qualify for Medicare if you have never worked, and those without any work history may even be eligible for premium-free Medicare Part A. Understanding your eligibility is an important first step toward securing the coverage you deserve.
Premium-Free Medicare Coverage Scenarios
Even if you never worked or didn’t work long enough, there are still some circumstances that could qualify you for premium-free Medicare coverage. These circumstances include your spouse’s work status and if you have a disability or a certain condition.
If you never worked but your spouse did, you should have premium-free Part A eligibility through them. Your spouse’s work history applies to you as well. This also applies if you are married, divorced or widowed.
- You are eligible if you have been married for at least one year and your spouse is eligible for Social Security disability or retirement benefits.
- You are eligible if you were married for at least 10 years and your spouse is eligible for Social Security disability or retirement benefits.
- Widow or widower
- You are eligible if you were married for at least nine months and are currently single and your spouse was eligible for Social Security benefits — either disability or retirement — before passing away.
But remember that you are not added to their plan due to Medicare acting as individual insurance. You will be able to disregard premiums on your own plan.
If your spouse worked and paid Medicare taxes but less than the full 40 quarters, you will not be eligible for premium-free Medicare through them.
Regardless of your work history, you can be eligible for premium-free Medicare if you have received Social Security or Railroad Retirement Board disability insurance for at least two years.
You’ll also be eligible if you have Lou Gehrig’s disease, also known as ALS, or end-stage renal disease. You can get Medicare before you turn 65 under any of these circumstances.
- End-Stage Renal Disease (ESRD)
- You must be diagnosed with ESRD and have received a kidney transplant or are receiving dialysis. If you are getting dialysis in your home, you can apply for Medicare on the day of your first treatment. If you receive dialysis in a treatment facility, you can apply for Medicare on the first day of the fourth month of your treatment.
- ALS (Lou Gehrig’s disease)
- You are automatically eligible for premium-free Medicare Part A as soon as your Social Security Disability Benefits begin. But there is a five-month waiting period when you sign up for SSDI before you start receiving either Social Security or Medicare benefits. Be aware of the time delay.
What You Can Expect To Pay
Regardless of your work history, different parts of Medicare come with respective price tags. However, whether or not you or your spouse worked will impact your premiums, so your Part A costs will be affected.
- Part A premium
- $505 a month if you don't qualify for premium-free coverage — which could drop to $278 if you spent some time in the workforce.
- Part B premium
- $174.70 — which is unaffected by your work status but could increase depending on your income level.
- Medicare Advantage
- Varied costs since these plans are provided through private insurers.
- Part D premium
- Cost varies by plan, but it will be more expensive if you have a higher income.
Do You Need Extra Help Paying Medicare Premiums?
If you never worked and are not eligible for premium-free Medicare, health care can become a considerable expense for you in retirement. There are some options available if you need help paying your Medicare premiums.
Medicaid is an assistance program designed to help cover your health care if you can’t afford other forms of insurance. You typically can only qualify for Medicaid if you have a very low level of income.
Medicare Savings Account — MSA
A Medicare Savings Account — or MSA — is a type of Medicare Advantage plan that includes a high deductible and a bank account to help pay for your health care costs. These may be an option if you are in good health and seldom go to a doctor or require a lot of medical care. Premiums are typically lower, but deductibles and out-of-pocket costs may be higher than other Medicare plans.
Medicare Savings Programs
Another option could be to take advantage of a Medicare Savings Program where your state can help you pay some of your Medicare costs like your deductible or coinsurance. According to the Medicare website, there are four different programs with their own qualifications, but you typically need to show that you have low income or lack of resources.
- Qualified Disabled and Working Individuals (QDWI) Program
- Qualified Medicare Beneficiary (QMB) Program
- Qualifying Individual (QI) Program
- Specified Low-Income Medicare Beneficiary (SLMB) Program
Supplemental Security Income (SSI)
You could also qualify for Supplemental Security Income (SSI) benefits to help lighten your financial burden. SSI benefits are available if you have limited income and are 65 and older, blind or have a disability.
Medicare Extra Help
An option that could help specifically with drug prices is the Medicare Extra Help Program. This program can pay your prescription drug costs, and you should be eligible for it if you qualify for Medicaid, a Medicare Savings Program or SSI benefits.
FAQs About Receiving Medicare If You Never Worked
11 Cited Research Articles
- Centers for U.S. Medicare & Medicaid Services. (2023, October 12). 2024 Medicare Parts A & B Premiums and Deductibles. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2024-medicare-parts-b-premiums-and-deductibles
- Mayo Clinic. (2022, October 13). Amyotrophic Lateral Sclerosis (ALS). Retrieved from https://www.mayoclinic.org/diseases-conditions/amyotrophic-lateral-sclerosis/symptoms-causes/syc-20354022
- U.S. Centers for Medicare & Medicaid Services. (2022, September 27). 2023 Medicare Parts A & B Premiums and Deductibles 2023 Medicare Part D Income-Related Monthly Adjustment Amounts. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly
- U.S. Social Security Administration. (2022, September). Medicare. Retrieved from https://www.ssa.gov/pubs/EN-05-10043.pdf
- U.S. Department of Health & Human Services. (2022, June). 4 Programs That Can Help You Pay Your Medical Expenses. Retrieved from https://www.medicare.gov/publications/11445-4-Programs-Help-Pay-Medical-Expenses.pdf
- U.S. Centers for Medicare & Medicaid Services. (2022). Costs. Retrieved from https://www.medicare.gov/basics/costs/medicare-costs
- U.S. Centers for Medicare & Medicaid Services. (2022). Costs of Medigap Policies. Retrieved from https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap/medigap-costs/costs-of-medigap-policies
- U.S. Centers for Medicare & Medicaid Services. (2022). Get Help With Costs. Retrieved from https://www.medicare.gov/basics/costs/help
- U.S. Centers for Medicare & Medicaid Services. (2021, December 1). Original Medicare (Part A and B) Eligibility and Enrollment. Retrieved from https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol
- U.S. Department of Health & Human Services. (2014, September 11). Who Is Eligible for Medicare? Retrieved from https://www.hhs.gov/answers/medicare-and-medicaid/who-is-eligible-for-medicare/index.html
- U.S. Social Security Administration. (n.d.). Medicare Information. Retrieved from https://www.ssa.gov/disabilityresearch/wi/medicare.htm
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