The short answer
Most people get Part A with no premium because they (or a spouse) worked and paid Medicare taxes for at least 10 years — 40 quarters, or credits. If you don't have 40 credits of your own, you're not shut out of Medicare. You may still get premium-free Part A on a spouse's record, or you can buy into Part A by paying a monthly premium.
This matters most for people who spent years out of the paid workforce, immigrants who came to the U.S. later in life, and anyone whose work simply didn't add up to 10 years of Medicare-covered employment.
Qualifying on a spouse's record
If your spouse has enough work credits, you can often get premium-free Part A based on their record once you're 65 and they're at least 62. This also applies in many cases to divorced spouses (if the marriage lasted long enough) and to widows and widowers. It's the first thing to check, because it can mean premium-free Part A even if you never had 40 credits yourself.
Part B is separate — its premium isn't based on work history, so you pay the standard Part B premium regardless. But getting Part A at no cost through a spouse still helps.
Buying into Part A
If neither your record nor a spouse's gets you to 40 credits, you can still enroll by paying a monthly Part A premium. The amount depends on how many credits you do have — people with some credits pay a reduced premium, and those with very few pay the full amount. You pair that with the standard Part B premium.
For immigrants and green-card holders, there's an additional residency requirement to be eligible to buy in. Our guide to Medicare eligibility for immigrants and green-card holders covers those rules, and our government help center points to programs that can lower costs.
Frequently Asked Questions
Can I get Medicare without 40 work credits?
Yes. You may qualify for premium-free Part A on a spouse's work record, or you can buy into Part A by paying a monthly premium. Part B is available regardless of work history.
How do I get Part A on my spouse's record?
If your spouse has 40 credits, you can often get premium-free Part A once you're 65 and they're at least 62. Divorced spouses and widows/widowers may also qualify under certain conditions.
How much does it cost to buy into Part A?
It depends on how many credits you have — people with some credits pay a reduced monthly premium, while those with very few pay the full amount, plus the standard Part B premium.
Do immigrants need extra requirements to buy Part A?
Yes. Lawfully present immigrants generally must also meet a residency requirement to be eligible to buy into Medicare. See our guide for immigrants and green-card holders for details.
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