Can I Get Medicare if I Don’t Have Enough Work Credits?

To get premium-free Medicare Part A when you turn 65, most people need to have at least 10 years of work credits. But what if you don’t meet the work credit requirement? The good news is that you still have options to get Medicare coverage.

In this comprehensive guide, we will cover:

• What Medicare work credits are
• How many credits you need for premium-free Part A
• What to do if you don’t have enough credits
• Alternate ways to qualify if you lack credits
• How much Part A costs if you pay a premium
• Strategies to avoid late enrollment penalties

What Are Medicare Work Credits?

First, let’s review what Medicare work credits are.

Social Security work credits, also called quarters of coverage, are based on your taxable earnings. You can earn a maximum of 4 credits per year.

In 2023, you get one work credit for each $1,640 of taxable earnings. So if you earn at least $6,560 in 2023, you will max out at 4 credits for the year.

These credits track how much you have paid into Medicare via payroll taxes during your working years. This is why they are used to determine eligibility for premium-free Medicare at age 65.

How Many Work Credits Do I Need for Free Part A?

To get premium-free Medicare Part A hospital coverage when you turn 65, most people need a total of 40 credits over their working lifetime.

Here is a summary of the work credit requirements:

• You can earn a maximum of 4 credits per year
• To get 1 credit in 2023, you need $1,640 in taxable earnings
• You need 40 credits (typically 10 years) for premium-free Part A

So if you worked full-time for 10 years, you likely earned enough credits for free Part A. But what happens if you come up short of the 40 credit requirement?

What If I Don’t Have Enough Work Credits for Part A?

If you don’t have the required 40 credits, you have two main options:

1. Buy into Part A

You can choose to purchase Medicare Part A coverage by paying a monthly premium. Many people aren’t aware you can buy into Part A.

The cost depends on how many credits you have:

• 30-39 credits: $274 monthly premium for Part A
• Less than 30 credits: $499 monthly premium

The standard Part B premium of $164 also applies if you buy into Part A.

2. Qualify through a spouse

You can get premium-free Part A based on your spouse’s work history under certain conditions, like:

• Being married at least 1 year
• Your spouse is eligible for Social Security or railroad retirement benefits
• Meeting marriage duration if divorced or widowed

So check if you qualify for free Part A through a current, former, or deceased spouse’s work record if you are short of credits.

Alternate Ways to Get Medicare Without Credits

In addition to buying in or using a spouse’s credits, there are a few other ways to get Medicare coverage even if you don’t have enough work credits:

Medicare disability benefits

You can qualify for Medicare before age 65 if you have received Social Security disability benefits for 24 months. This path to Medicare does not require any work credits.

End-stage renal disease (ESRD)

If you require regular dialysis or a kidney transplant for permanent kidney failure, you can get Medicare at any age without work credits through ESRD coverage.

Amyotrophic lateral sclerosis (ALS)

Also known as Lou Gehrig’s disease, people with ALS qualify for Medicare the month their Social Security disability benefits begin, regardless of work history.

Premium Part B

Part B covers doctor visits and outpatient care. You can enroll in premium Part B at 65 without any work credits required. The standard premium is $164 per month (may be higher based on income). You must buy into Part A to get Part B.

How Much Does Part A Cost If You Pay a Premium?

If you don’t have enough work credits, here is how much you will pay for Part A in 2023 based on your credits:

• 30-39 Credits: $274 per month
• Less than 30 Credits: $499 per month

And remember, you must also pay at least $164 per month for premium Part B as well if you buy into Part A.

Medicare also charges late enrollment penalties if you delay signing up past your initial enrollment period. Let’s look at how to avoid these penalties.

How to Avoid Medicare Late Enrollment Penalties

Medicare charges permanent late enrollment penalties if you don’t sign up for Part A and/or Part B when you are first eligible. These penalties are 10% of the premium for each full 12-month period you delay enrollment.

Here are some tips to avoid penalties:

• Enroll in Part A – Even if you have to pay premiums, it is best to enroll in Part A when you turn 65 to avoid penalties. You can always drop Part A later if you want.

• Take Part B – If you plan to buy into Part A, make sure you also enroll in Part B during your initial enrollment period to sidestep penalties.

• Check deadlines – Consult ssa.gov to see when your initial enrollment period begins and ends based on your birthdate. Mark your calendar so you don’t miss your window.

• Review options yearly – During Medicare open enrollment each fall, assess your healthcare needs and coverage. Adjust your Medicare enrollment if needed.

• Provide creditable coverage info if you delayed Part B due to having coverage through an employer. This proves you had a valid reason to postpone Part B.

Avoiding late penalties takes some planning. But with a little effort, you can prevent permanent surcharges.

Key Takeaways

The main points about getting Medicare if you lack sufficient lifetime work credits include:

• You can buy into Part A if you pay monthly premiums
• You may qualify for free Part A based on a spouse’s work record
• Other paths like disability or ESRD allow access without credits
• Paying premiums for Parts A and B keeps you penalty-free

Understanding that credits aren’t the only path to Medicare provides options. Speak with a Medicare counselor if you still have questions about qualifying for coverage.