Can You Get Medicare If You Never Worked?

You can still get Medicare if you never worked, but it will likely be more expensive. Unless you worked and paid Medicare taxes for 10 years — also measured as 40 quarters — you will have to pay a monthly premium for Part A. This may differ depending on your spouse or if you spent some time in the workforce. You will also pay a premium for Part B regardless of work history.

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 likely will not be eligible for premium-free Part A, which covers inpatient care and hospital stays.

You can still get Part A without any work history; to do so, 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 never worked, then your Part A premium for 2021 will be $471. But if you spent at least 30 to 39 quarters in the workforce and paid Medicare taxes, your premium could be reduced to $259.

Medicare Part B, which covers outpatient care, comes with a monthly premium that is not affected by your work history.

Learn More About Medicare Eligibility

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.

Spousal Eligibility

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.

But remember that you are not added to their plan because Medicare is individual insurance. You will be eligible not to pay premiums on your own plan.

If your spouse worked and paid Medicare taxes but not for a full 40 quarters, then you will not be eligible for premium-free Medicare through them.

Disability Eligibility

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.

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Paying for Medicare

Regardless of your work history, different parts of Medicare come with respective price tags. Since your decision on whether or not you worked will impact your premiums, your Part A costs will be affected.

Medicare Costs
Part A premium:
$471 a month if you don't qualify for premium-free coverage — which could drop to $259 if you spent some time in the workforce.
Part B premium:
$148.50 — 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.
Medigap:
Costs vary by plan and insurer.

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.

You may want to look into Medicaid, 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.

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 also could 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 Extra Help. 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.

Last Modified: September 13, 2021

7 Cited Research Articles

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