Can You Get Medicare If You 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.

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.

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.

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.

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.

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.

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.

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.

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.