Medicare is a national health insurance program for persons older than 65 and managed by U.S. federal government. It consists of four parts, Part A – hospital insurance, Part B – medical insurance, Part C – Medicare Advantage, and Part D – prescription drug coverage. Each part covers different healthcare services, and they are complementary, not in competition. The program is the same in every state because it is regulated on a federal level.
In this blog, we will answer by parts if you can enroll in Medicare if you have never worked.
Are you eligible for Medicare if you have never worked?
As for anything Medicare-related, it depends. In general, eligibility requirements for Medicare are:
- be a U.S. citizen or permanent resident for at least 5 years in a row
- be 65 years old or older
- if you receiving Social Security disability benefits for at least 24 months
- if you have been diagnosed with ESRD (End-Stage Renal Disease) or ALS (Amyotrophic Lateral Sclerosis)
So if you read carefully, you will see that there is no work requirement listed in the eligibility criteria. The easiest answer to the question asked is, yes you can have Medicare if you never worked, but you will pay for it more expensive. The only exception from this is if you are married, and your spouse has been working for 10 years while paying Medicare taxes. In that case his/her benefits apply to you too. Let`s breakdown how much more and why you will be paying more for Medicare if you have never worked and do not have the benefits of a married couple.
Medicare Part A
Medicare Part A is a hospital insurance that covers almost all hospital-related costs. Eligibility for Medicare Part A is the same as for every other part of Medicare, listed above. So, you can enroll in Medicare Part A if you have never worked. However, Part A is premium-free for most beneficiaries. The only requirement for qualifying for premium-free Medicare Part A is that you have been paying for Medicare taxes while working for at least 40 quarters (10 years). If you have not been paying Medicare taxes through work, then you will have a premium for Medicare Part A, and it will be high. How much the premium would be depend on the time you spent working, and if you have never worked, you can still enroll in Part A but with the highest premium of $499 per month.
Medicare Part B
Medicare Part B is a medical insurance designed to give coverage for outpatient medical care. Eligibility for Medicare Part B has the same requirements as other parts of Medicare, so from that only the answer to our question is clear. You can enroll in Medicare Part B if you have never worked. There is no work history requirement for Part B enrollment. Because Part B has a monthly premium that is for every beneficiary, there is no work or tax requirement that affects your premium. The standard Part B premium in 2023 will be $164.90.
Medicare Part C
Medicare Part C is commonly known as Medicare Advantage. It is a health insurance program provided through private insurance companies approved by Medicare. All Medicare Advantage plans must have at least the same coverage as it is offered through Original Medicare – Part A and Part B. However, often there are some additional benefits bundled in one plan, such as DHV services, SilverSneakers membership, etc. Eligibility for Medicare Advantage is the same as for other parts of Medicare. To enroll in Part C you must meet eligibility criteria and already be enrolled in Original Medicare. If you have never worked you can still enter into the Medicare Advantage plan, without any penalties. Because it is sold through private companies that set their premiums and costs for every plan, there is no work requirement needed. You will pay the same amount for a chosen plan as a person who has worked for 10 years.
Medicare Part D
Medicare Part D is prescription drug coverage. It provides you with coverage for needed medications that are listed on the general formulary. The eligibility criteria for Part D are the same as for other parts of Medicare. Since Medicare Part D has its own premium, like Part B, there is no work requirement that affects its enrollment. If you have never worked, you still can enroll in Part D while regularly paying the Part D premium, which is $43 in 2023.
Conclusion
All in all, there is a simple answer to the question if you can have Medicare if you never worked. And that is yes, you can have Medicare if you never worked. You will only pay for it more than other beneficiaries that have been working and paying Medicare taxes while employed. The only huge difference between you and people who has been working and paying Medicare taxes is in Medicare Part A premium. For those who were paying taxes through employment, the Part A premium is free. And for those who have not been working and paying taxes premium can be up to $499 per month. But if you are married and your spouse has been working and paying Medicare taxes, then his/her benefits apply to you as well. In all other parts of Medicare, work time has no effect on eligibility for each part. So, in general, if you have never worked you can still become a Medicare beneficiary.
Craig W. Hansen is an insurance professional and co-founder of William & Michael Advisor Group LLC and Jersey Insurance Solutions. Craig has served his clients in many facets of the insurance industry, always with the same goal: excellence in service while building solid, long-term, lasting relationships. With over a decade of experience in the insurance benefits industry, Craig’s clients know they can call on him anytime and receive platinum service with a smile.
