You can sign up for Part A alone if you have enough work credits

Medicare Part A covers hospital stays, skilled nursing care, hospice, and some home health services. You can sign up for Part A without Part B (doctor visits and outpatient care) if you meet one condition: you or your spouse paid Medicare taxes for at least 10 years (40 quarters of work). If you have fewer than 10 years of work history, you cannot get Part A alone — you would need to buy both Part A and Part B together, or neither.

Most people become may be able to access for Part A at 65 if they have the required work credits. You do not automatically get it — you have to sign up. The process is straightforward and takes about 10 minutes online, by phone, or in person at a Social Security office.

Key Takeaways

  • You can sign up for Part A only if you or your spouse worked and paid Medicare taxes for at least 10 years.
  • Sign up through Social Security online at ssa.gov, by calling 1-800-772-1213, or at your local Social Security office.
  • You can sign up starting three months before the month you turn 65, and you have until three months after.
  • If you miss the important date, you may pay a permanent penalty on your Part A premium, so sign up on time even if you do not plan to use it right away.
  • Part A coverage begins the first day of the month you turn 65, or the first day of the month after you sign up, whichever is later.

Check your work history before you sign up

Social Security keeps a record of your work credits. You earn one credit for each quarter (three months) you work and pay Medicare taxes, up to four credits per year. You need 40 credits total — roughly 10 years of work — to may have access to for Part A at no monthly premium.

Before you sign up, check your work record to make sure Social Security has it right. Go to ssa.gov, create a my Social Security account, and view your earnings record. If you see missing years or incorrect amounts, contact Social Security to correct them. This takes time, so do it at least a few months before you turn 65.

If you have fewer than 40 credits, you cannot get Part A alone. You would have to buy Part A and Part B together (called "Part A/B enrollment"), or you can choose not to enroll in Medicare at all. Talk to a Social Security representative about your options if this applies to you.

Sign up through Social Security

You have three ways to sign up for Part A: online, by phone, or in person. All three routes go through Social Security, not Medicare directly.

Online: Go to ssa.gov and sign into your my Social Security account. Click "Medicare" and follow the steps to request Part A. You will need your Social Security number and basic information. You can finish in about 10 minutes. Social Security will send you a confirmation by mail.

By phone: Call Social Security at 1-800-772-1213. A representative will ask for your Social Security number, date of birth, and whether you want Part A only or Part A and Part B. The call takes about 15 minutes. Ask for a confirmation number before you hang up.

In person: Visit your local Social Security office. Bring your Social Security card and a photo ID. You can find your office location at ssa.gov/locator. Walk-ins are welcome, but wait times vary. Call ahead if you want to schedule an appointment.

When to sign up and what happens if you miss the important date

You can sign up for Part A starting three months before the month you turn 65. For example, if you turn 65 in June, you can sign up starting in March. You have until three months after the month you turn 65 to sign up without penalty — in this example, until the end of September.

If you sign up during this window, your coverage begins on the first day of the month you turn 65. If you sign up after the important date, your coverage begins the first day of the month after you sign up.

If you miss the important date, you will pay a permanent 10% penalty on your Part A premium for as long as you have Part A. This penalty does not go away, even if you sign up years later. For this reason, sign up during the window even if you do not plan to use Medicare right away or if you are still working.

What you need to have ready when you sign up

Signing up is fast because Social Security already has most of your information. Have these items on hand:

  • Your Social Security number
  • Your date of birth
  • Your citizenship or immigration status (if you are not a U.S. citizen, you must have been a permanent resident for at least five years)
  • Your current mailing address

If you are signing up online or by phone, that is all you need. If you are signing up in person, bring your Social Security card and a photo ID (driver's license, passport, or state ID).

What happens after you sign up

Social Security will mail you a Medicare card within two to four weeks. The card shows your Medicare number and which parts of Medicare you have (in your case, Part A only). Keep this card with you and show it to hospitals and other providers.

You will also receive a document called Your Medicare Coverage, which explains what Part A covers and what you pay. Read it so you understand your deductible and copayments. Part A has a deductible for hospital stays (the amount you pay before Medicare starts paying), and it changes each year.

If you have questions after you sign up, call Medicare at 1-800-MEDICARE (1-800-633-4227). They can answer questions about your coverage, costs, and what to do when you need hospital care.

Frequently Asked Questions

What if I am still working at 65 — do I still have to sign up for Part A?

Yes. Even if you are working and have employer health insurance, you should sign up for Part A during your enrollment window. Part A is inexpensive (often free if you have 40 work credits), and missing the important date triggers a permanent penalty. Your employer insurance will be primary, and Part A will be secondary, but you still need to enroll.

Can I sign up for Part A and delay Part B?

Yes. Part A and Part B are separate. You can sign up for Part A only and decide about Part B later. If you do not sign up for Part B when you first become may be able to access, you can sign up during the General Enrollment Period (January 1 to March 31 each year), but you may pay a penalty. Talk to Social Security about your specific situation.

What if I worked outside the United States — do those years count?

It depends on the country and the agreement between that country and the United States. Some countries have totalization agreements that allow work credits earned there to count toward Medicare. Contact Social Security to learn about your work history qualifies. This can take several weeks to verify, so ask early.

Do I have to pay a monthly premium for Part A if I have 40 work credits?

No. If you or your spouse paid Medicare taxes for 40 quarters, Part A is free. If you have fewer than 40 credits, you can buy Part A, but it costs a monthly premium (the amount varies). Social Security will tell you the cost when you sign up.

What if Social Security says I do not have enough work credits?

Ask Social Security to review your earnings record in detail. Sometimes credits are missing because an employer reported wages under a different name or Social Security number. If you find errors, Social Security can correct them, but you need documentation (old tax returns, W-2s, or pay stubs). If your record is correct and you do not have 40 credits, you cannot get Part A alone, but you can explore other coverage options with a Social Security representative.