Most people 65 and older get free Medicare Part A if they or their spouse paid Medicare taxes for at least 10 years

Medicare Part A covers hospital stays, skilled nursing care, hospice, and some home health services. You do not pay a monthly premium for Part A if you have worked and paid Medicare taxes (the 1.45% taken from your paycheck) for at least 10 years — whether those years were consecutive or not. The IRS counts any quarter where you earned at least a certain amount as a credit toward the 10-year requirement, so gaps in work do not erase earlier credits.

If you are 65 or older and meet the 10-year work history requirement, you are may have access to to free Part A. You do not have to be retired, and you do not have to be a U.S. citizen — you must be a permanent resident who has lived in the United States for at least five years. Your spouse's work history counts too: if your spouse paid Medicare taxes for 10 years, you may be may have access to to free Part A based on their record, even if you never worked.

Some people under 65 also get free Part A. This includes people who have received Social Security Disability Insurance (SSDI) for at least 24 months, people with end-stage renal disease (ESRD), and people with amyotrophic lateral sclerosis (ALS). These groups do not need a 10-year work history.

Key Takeaways

  • You get free Part A at 65 if you or your spouse paid Medicare taxes for at least 10 years total, whether or not those years were consecutive.
  • If you do not have 10 years of work history, you can buy Part A with a monthly premium that varies based on how many years you or your spouse worked.
  • People under 65 with SSDI for 24 months, ESRD, or ALS get free Part A regardless of work history.
  • You must sign up for Part A during your initial enrollment period or face a late enrollment penalty if you wait.
  • Your work history is tracked through your Social Security record, so you can check your credits online or call Social Security to verify you have enough.

How Medicare counts your work history

Medicare uses work credits to measure your may be able to access. Each year you work and pay Medicare taxes, you earn up to four credits — one for each quarter (three-month period) where you earn a minimum amount. In 2024, you earn one credit for each $1,550 you make, up to four credits per year. The dollar amount changes yearly, but the system stays the same.

You need 40 credits total to be may have access to to free Part A at 65. Since you can earn up to four credits per year, this typically means 10 years of work. However, the years do not have to be recent or consecutive. If you worked for five years in your 30s and five years in your 50s, you have 40 credits and you may have access to. If you worked part-time and earned less each year, it may have taken you longer to accumulate 40 credits, but they still count.

You can check your work credits by creating an account on ssa.gov and viewing your Social Security Statement. This statement shows how many credits you have earned and estimates your future benefits. If the number seems wrong, you can contact Social Security at 1-800-772-1213 to request a correction.

What happens if you do not have 10 years of work history

If you reach 65 without 40 work credits, you are not may have access to to free Part A, but you can still buy it. The monthly premium depends on how many credits you have. If you have 30 to 39 credits, your premium is about half the standard amount. If you have fewer than 30 credits, you pay the full premium. These amounts change each year.

You must sign up for Part A during your initial enrollment period — the three months before the month you turn 65, the month you turn 65, and the three months after. If you do not sign up during this window and you do not have a valid reason for the delay, you will owe a 10% premium increase for twice the number of months you were late. This penalty is permanent and applies for as long as you have Part A.

If you are still working at 65 and have employer health insurance, you may be able to delay Part A without penalty. You must have coverage through your own current employment (not your spouse's), and you must sign up within eight months of leaving that job or losing the coverage. Talk to your employer's benefits office about whether this exception applies to you.

may be able to access for people under 65

You can get free Part A before 65 if you have received SSDI for at least 24 consecutive months. The 24-month clock starts the month Social Security approves your disability claim, not the month you applied. Once you have been on SSDI for 24 months, you are automatically enrolled in Part A — you do not have to do anything. Part A begins the first day of the month after your 24-month waiting period ends.

People with end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — are may have access to to free Part A regardless of age or work history. Coverage typically begins the first day of the month in which you start dialysis or receive a kidney transplant. If you have ESRD, your nephrologist's office or dialysis center can help you understand when your Part A coverage starts.

People diagnosed with amyotrophic lateral sclerosis (ALS) are also may have access to to free Part A without the usual waiting periods. Part A coverage begins the first day of the month you are diagnosed, and you do not have to wait for SSDI approval. If you have been diagnosed with ALS, contact Social Security to report this and confirm your Part A enrollment.

How to verify your may be able to access before you turn 65

The best time to check your work credits is at least three months before you turn 65. Go to ssa.gov, create a my Social Security account, and view your Social Security Statement. This shows your lifetime earnings and the number of credits you have earned. If you see an error — for example, a year of work that is not listed — you can request a correction by filing Form SSA-7008 with Social Security.

If you do not use the internet, you can call Social Security at 1-800-772-1213 and ask a representative to review your work history with you. Have your Social Security number ready, and be prepared to provide information about your employment history. Social Security can tell you on the phone whether you have 40 credits and whether you will be may have access to to free Part A.

If you are close to 40 credits but not quite there, ask Social Security whether any recent work might push you over the threshold. Sometimes a few more months of work can mean the difference between free Part A and a monthly premium for the rest of your life.

What to do if you are not sure about your may be able to access

If your work history is complicated — for example, you worked in another country, were self-employed, or had periods of no earnings — contact Social Security before you turn 65. Explain your situation and ask them to review your record. Social Security can tell you whether your foreign work counts, how self-employment income is credited, and whether any gaps affect your may be able to access.

If you are explore for Part A based on your spouse's work history, you will need your spouse's Social Security number and permission to discuss their record. Social Security can confirm whether your spouse has 40 credits and whether you are may have access to to free Part A as a spouse.

Do not wait until you turn 65 to find out you are not may have access to to free Part A. The enrollment period is only seven months long, and if you miss it, you will face a permanent premium increase. Call Social Security now at 1-800-772-1213 to verify your may be able to access.

Frequently Asked Questions

Do I have to be retired to get free Part A?

No. You are may have access to to free Part A at 65 if you have 40 work credits, whether you are still working or retired. You do not have to stop working to claim Part A. However, if you are still working and have employer health insurance, you may be able to delay Part A without penalty.

If my spouse has 40 credits but I do not, can I get free Part A?

Yes. You can be may have access to to free Part A based on your spouse's work history if your spouse has 40 credits. You must be at least 62 years old (or any age if you are caring for your spouse's child under 16). Contact Social Security to report your spouse's work history and confirm your entitlement.

What if I worked in another country before moving to the United States?

Work in some countries may count toward your 40 credits under totalization agreements between the U.S. and that country. Contact Social Security and tell them which countries you worked in. They can review your record and determine whether any of that work counts.

Can I get free Part A if I am not a U.S. citizen?

Yes, if you are a permanent resident (green card holder) who has lived in the United States for at least five years and have 40 work credits. You do not have to be a citizen. Bring your green card and proof of your five-year residence when you sign up for Part A.

What happens if I sign up for Part A late?

If you do not sign up during your initial enrollment period and you do not have a valid reason for the delay, you will owe a 10% premium increase for twice the number of months you were late. This penalty is permanent. For example, if you are two years late, you pay 20% more forever. Sign up as soon as you realize you missed the important date to limit the penalty.