Are you over 65, have not worked, and are uncertain about your healthcare options? If so, you’ll be glad to know that Medicare can provide coverage and protection in this situation. However, some may wonder if they qualify for Medicare when they haven’t held down a full-time job.

This article will answer all of your questions regarding the requirements for getting Medicare if you have never worked or were self-employed. We’ll also discuss how to apply for Medicare benefits and what programs you may be eligible for even without a work history.

Having Medicare can help significantly cut down your expenses when the time comes that you will be needing medical care. This federal health insurance program benefits older adults who have worked for a certain amount of time in the workforce.

While most of its beneficiaries are people who have paid Medicare taxes through employment, it can also be available to eligible individuals who have never been employed.

Read on below to learn more about what you need to know to get Medicare coverage if you’ve never worked.

Medicare Eligibility- Who Qualifies?

To be able to enjoy the program’s benefits, you must first be eligible to receive Medicare. Some individuals will be automatically enrolled, while others must sign up themselves.

Those who are already receiving Social Security benefits or Railroad Retirement benefits are automatically enrolled in Part A (hospital coverage) and Part B (medical coverage) when they turn 65. If you do not fall into these categories, you will need to actively enroll in Medicare.

You become eligible for Medicare if you are:

  • an individual who is 65 years or older and a US citizen or a permanent legal resident who has lived in the country for at least five years
  • an individual under 65 years old who has certain medical conditions (Lou Gehrig’s disease, or permanent kidney failure)

You can find out if you are eligible for Medicare and know the premium you have to pay with the Medicare Eligibility & Premium Calculator.

How Much Do You Need To Work to Receive Medicare?

To qualify for premium-free Medicare Part A, you will need to have 40 work credits. That is equal to about 10 years of being in the workforce and paying FICA taxes. When you have attained enough credits, you will automatically get Part A (hospital coverage) when you become eligible for Medicare.

Unlike Part A, Medicare Part B is rarely free unless you are a low-income individual who is enrolled in the Medicare Savings Program. To receive Part B (medical coverage), you need to pay a monthly premium, which will depend on your income and other factors. The standard premium for Medicare Part B in 2022 is $164.90 in 2023.

If You Never Worked in The US, Can You Get Medicare?

Yes, you may still receive Medicare even if you have no work experience in the US. However, it will be more costly. You will have to pay the monthly premiums for each coverage area (Part A, B, etc…) that you want to purchase. Keep in mind that the costs of monthly premiums can increase or decrease every year.

Cost of Medicare if You Have Never Worked

If you haven’t worked long enough to qualify for premium-free Part A, you can still get Medicare. However, you will have to pay monthly premium costs for each Part that you purchase. In 2022, the cost of Medicare Part A for those with less than 30 credits is $499. Those who have 30 – 39 credits will need to pay $274 a month.

**People often confuse Medicare and Medicaid. While there can be some overlap, it’s important to understand the differences between the two. Check out our in-depth coverage on the topic, Medicare vs Medicaid: Important Differences You Should Know.

Medicare Coverage of Dependents

While most insurance programs extend beyond the primary holder’s coverage, this is not the case for Medicare. Since it is not family insurance, it does not cover dependents. If your non-working spouse or family member needs Medicare, they will need to be eligible and pay the corresponding premiums to get coverage.

Can I Get Medicare Through My Spouse?

Medicare doesn’t offer joint insurance plans and spouses can’t be included in your coverage. However, you may be able to qualify for premium-free Medicare Part A based on your spouse’s work history.

If you are 65 years old and eligible for Medicare but haven’t reached the required tax contributions, you can get premium-free Part A if your working spouse has made enough contributions through his/her employment.

This also works if:

  • You are divorced and your ex-spouse is eligible for Social Security benefits. Your past marriage should be at least 10 years and you should be currently unmarried.
  • You are a widow/widower and were married to your spouse for at least nine months. You must also be currently unmarried.

Does Medicare Cover My Spouse Who Is Under 65 Years of Age?

No, Medicare does not cover a spouse who is under 65 years of age. Because Medicare offers individual coverage only, your spouse will not be included in your plan.
To get coverage, your spouse will need to meet eligibility requirements. If they are under 65 years old, they can only qualify for Medicare by disability.

No Work Doesn’t Mean No Medicare

Never having worked or being self-employed does not automatically disqualify you from receiving Medicare benefits. As long as you are over 65 and a legal U.S. citizen or resident, you should be able to qualify for some form of Medicare coverage.

There are several programs (Parts) within Medicare that provide different levels of coverage, so even if you have never worked before, you can still get the care and protection you need through this important government healthcare program.

To apply for benefits, simply contact your nearest Social Security office or visit the official Medicare.gov website to begin the process. Do you have additional questions about work history and Medicare? Let us know in the comments below!

Medicare and Work History Frequently Asked Questions

Is everyone eligible for Medicare?

No, not everyone is eligible to get Medicare benefits. You need to be over 65 years, a US citizen, and have contributed for at least 10 years while in the workforce. Those who don’t meet these qualifications can still get Medicare but have to pay additional monthly premiums.

Is my spouse eligible for Medicare if she never worked?

If your spouse is over 65 years old and has never worked, she can still be eligible for Medicare. She will have to pay a monthly premium, which will depend on her work credit and tax history. If your tax history meets the requirements, your spouse may be eligible for premium-free Medicare Part A.

Is Medicare Part A free?

For most people, Medicare Part A is free. Individuals who meet the required number of quarters of coverage don’t need to pay a premium for coverage. Those who do not have enough work credits and contributions will need to pay a monthly premium to get Part A coverage.

How much is the monthly premium for Medicare?

The monthly premium will depend on a variety of factors including the specific coverage, your tax contributions, how much you earn, and the current year. For Part A, the premium is $274 or $499 in 2022. For Part B, the premium is $170.10 monthly in 2022, or higher, depending on your income.

When can I enroll in Medicare?

The initial enrollment period lasts for seven months, starting three months before you turn 65 and ending three months after your birthday month. Late enrollment can result in penalty fees. If you miss your initial enrollment period, you can enroll during the general enrollment period, which takes place from January 1 – March 31 of each year.

Amie has worked with older adults and their families for the past twenty-plus years of her career. Her senior care knowledge is based on her experience as a social worker, family caregiver, and senior care consultant.

An expert in senior care, Amie has professional and personal experience in senior housing, caregiving, end-of-life care, and more from her 24 years of working with older adults.