If you are 65 or older and a U.S. citizen or have been a permanent resident for at least five years, you can pay monthly premiums to receive Part A and Part B. You can otherwise qualify for Medicare if you have certain chronic conditions or have received disability benefits for at least two years. Even if you have never worked, you may qualify for premium-free Part A.
Qualifying with a Disability
Those who qualify due to a disability are not restricted by the age requirement, and can be under the age of 65 when receiving benefits. After you have received Social Security Disability Insurance for 24 months, you will begin to receive Medicare benefits. You are automatically enrolled, and your Medicare card will be mailed to you.
With amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease), you start receiving Medicare benefits immediately after you begin receiving Social Security Disability Insurance.
With End Stage Renal Disease (ESRD) or kidney failure, you qualify for Medicare benefits if:
- You qualify for Social Security retirement benefits
- You qualify for Railroad Retirement Board benefits
- Your spouse or parent worked as a government employee or paid social Security taxes for at least 40 quarters while working
Qualifying for Premium-Free Part A
Premium-free Part A is the Social Security benefit that Americans earn by working for a certain length of time and having their pay taxed. Other circumstances that merit paying no premiums include having certain conditions or receiving Medicare benefits due to disability. There are several ways to qualify for premium-free Part A, and many do not require that you personally worked.
You qualify if your spouse worked for at least 40 quarters (10 years or 40 work credits). While they worked, their pay was taxed by the Federal Insurance Contributions Act, which funds Medicare. If your spouse worked for 30 to 39 quarters, you will pay $259 each month, and if they worked for fewer than 30 quarters, you will pay $471 each month in 2021. If you buy Part A, you also have to buy Part B, which has a premium of $148.50 each month in 2021.
Those qualifying through a chronic condition or disability will receive premium-free Part A as soon as they are eligible to receive Medicare benefits. Generally, you are qualified to receive premium-free Part A if you are:
- Already receiving retirement benefits from Social Security or the Railroad Retirement Board
- Eligible to receive benefits from Social Security or Railroad Retirement but have not filed for them yet
- Married to someone who had Medicare-covered government employment
- Under 65 and have received Social Security Disability Insurance or Railroad Retirement Board disability benefits for 24 months
- Suffering from End-Stage Renal Disease and meet the conditions outlined previously for Medicare eligibility