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Nov. 10, 2025

Can you get Medicare if you never worked?

It’s normal to feel unsure if you’ve never paid into the system through a regular job. But Medicare is still available to you. You can qualify through your spouse, pay for coverage yourself, or get help from state programs.

Medicare is a health care program funded by the federal government for Americans 65 and older, as well as some other people who meet specific requirements. You don’t need to have worked a job or paid payroll taxes to be eligible. This means that even if you’ve never had a U.S.-based job, you might still qualify for Medicare benefits.1

There are many reasons why someone might not have worked in the United States. When it comes to Medicare, this usually doesn’t affect your eligibility. If you’ve never worked, you can still learn about how to enroll and what the costs might be.

What qualifies someone to get Medicare?

According to the Centers for Medicare and Medicaid Services (CMS), you must meet three basic requirements to be eligible for Medicare enrollment:1

  • You must be at least 65 years of age.
  • You must be a U.S. citizen or permanent resident.
  • You must have lived in the United States for at least five continuous years.

This means you don’t have to be retired or getting Social Security benefits to sign up for Medicare. Also, there’s no rule that says you need to have a job to enroll.

However, your past work history might affect whether you have to pay for different parts of Medicare. For example, you might have to pay a premium for Medicare Part A (Hospital Insurance) if neither you nor your spouse has worked for at least 10 years.2

Can you get Medicare if you’ve never worked?

Yes, you can still get Medicare even if you’ve never worked. But you might have to pay for certain parts of it.

If you didn’t already know, Medicare is split into multiple parts, each covering different things.3

  • Medicare Part A: Also known as Hospital Insurance, Medicare Part A helps pay for hospital stays.
  • Medicare Part B: Also known as Medical Insurance, Medicare Part B helps pay for health care and medical equipment. This includes things like preventive care, doctor visits, screenings, and durable medical equipment.
  • Medicare Part C: Also known as Medicare Advantage, Medicare Part C plans are offered by private companies approved by Medicare. These plans include the coverage from Medicare Part A and B, and usually Part D as well. The costs for these plans can be very different.
  • Medicare Part D: Medicare Part D covers prescription drugs. The costs and drug coverage can vary.
  • Medigap: You can buy this type of Medicare plan from private companies to help pay for Medicare Part A and Part B. To be eligible, you need to be enrolled in certain plans.

Each part of Medicare has its own costs and rules. Some rules might depend on whether you have worked. Make sure to review each part’s rules to understand your out-of-pocket costs.

Understanding Medicare Part A if you’ve never worked

Medicare Part A provides coverage for some home health care services, hospice, skilled nursing facility care, and, most commonly known, inpatient hospital care. For this part of Medicare, if you have worked during your life. While employment status doesn’t affect your eligibility for Medicare Part A, it does determine if you can get it without paying a premium.

If you or your spouse have worked and paid Medicare taxes for at least 10 years, you will probably qualify for no-cost coverage. The premiums are based on your work history. Here are the projected Medicare Part A premiums for 2025:4

  • Less than 30 quarters of work history: $518/month
  • Between 30 and 39 quarters of work history: $285/month
  • More than 39 quarters of work history: $0/month

It’s also important to remember that deductibles for Medicare Part A are $1,676 per benefit period.5 As such, navigating Medicare Part A if you don’t qualify for premium-free enrollment can be tricky and expensive.

Understanding Medicare Part B if you’ve never worked

Unlike Medicare Part A, Medicare Part B costs are not based on your or your spouse’s work history. Most people pay a monthly premium for Part B coverage, no matter what their past employment was. In 2025, the monthly premium is $185, but it could be higher for people who earn more.5

Can you qualify for Medicare through your spouse’s work history?

You can qualify for Medicare if you meet the standard eligibility rules, no matter if you are married or have worked.

Medicare Part A premiums are determined by you and your spouse’s work history. This means you can qualify for premium-free Medicare Part A depending on your or your spouse’s past employment status. This means that if you didn’t work throughout your lifetime, but you’re at least 65 years old and married for at least 1 year (and your spouse has worked and paid Medicare taxes for 10 years), you may qualify for no-premium Medicare Part A coverage.1

Even if you’re divorced, you can still get free Medicare Part A if your marriage lasted at least 10 years and you are not married now. You can also get free Medicare Part A if you are a widow or widower, as long as you were married for at least 9 months.

Getting Medicare through disability

Medicare is usually thought of as insurance for people over 65, but it’s also available for people with certain disabilities. This means that if you’ve received Social Security Disability Insurance (SSDI) for at least 24 months (two years), you become eligible to enroll in Medicare, regardless of whether you’ve worked.6 Long-term disabilities, amyotrophic lateral sclerosis (ALS) and end-stage renal disease (ESRD) are examples of conditions where you could get Medicare through having a disability.4

How to apply for Medicare if you’ve never worked

Whether you’ve worked or not doesn’t change how you apply for Medicare. Most people sign up through the Social Security Administration at www.ssa.gov/medicare. You can also call 1-800-772-1213 or visit your local Social Security office to start your application.7

Be sure to have the following information prepared when you start your application:

  • Your Social Security number
  • Where you were born (city, state, country)
  • Start and end dates for any group health plans you’re currently enrolled in or any group health plans you may be enrolled in after age 65
  • Valid email address (for Part B only)
  • Your existing Medicare number (for Part B enrollment)

You might need to show proof of your work history during the application process. If you’re applying based on your spouse’s work record, you may need to provide marriage documents, just like if you were divorced. Talk to a Social Security representative to find out what papers you need to enroll.

When can I enroll in Medicare?

You can’t sign up for Medicare anytime you want—there are specific times when you can enroll in a plan.

Your Medicare Initial Enrollment Period starts three months before you turn 65. It lasts for seven months: three months before your birthday, the month of your birthday, and three months after your birthday. If you miss this time, you’ll have to wait until the general sign-up period, which is from January 1 to March 31 each year.8

Outside of these two enrollment periods, the only other time you’d be able to enroll in Medicare would be if you qualified for a Special Enrollment Period, which could be triggered by an event such as losing your job’s health insurance.

Knowing when you can enroll in Medicare can help prevent gaps in coverage. Review this chart from CMS to understand your options for enrolling in Medicare.

Help paying for Medicare if you’ve never worked

If you don’t get Medicare Part A for free, paying for Part A and Part B can cost a lot. Here’s what you might need to pay each month without help:

  • Part A premium: $285 or $518
  • Part B premium: $185
  • Average Part D premium: $30 to $40 (varies by plan)

These costs can feel really overwhelming. Here are some options to help you manage them:

  • Medicaid: A joint federal and state program that can help with premiums, deductibles and coinsurance.
  • Medicare Savings Programs (MSPs): State programs that help pay Part A and/or Part B costs.
  • Extra Help: A federal program to reduce out-of-pocket costs for prescription drugs under Part D.
  • PACE (Programs of All-Inclusive Care for the Elderly): Helps people who need nursing-home-level care to stay in their community.

Final thoughts

It’s normal to feel unsure if you’ve never paid into the system through a regular job. But Medicare is still available to you. You can qualify through your spouse, pay for coverage yourself, or get help from state programs. There are ways to make it work. Take time to look at your options, apply early, and use support resources to make sure you get the care and coverage you need.

Disclaimer

For full information, visit www.medicare.gov or call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week.

References

Medicare Articles