Can You Get Medicare If You Never Paid Into Social Security
The Federal Insurance Contributions Acts establishes that every working American must contribute 6.2% of their pay to Social Security and 1.45% of their pay to Medicare .
In exchange, when you turn 65 years old, you are eligible to use Medicare for your health insurance, with any monthly premiums being deducted from your Social Security check .
- If you have paid FICA taxes for at least 40 quarters through employment, you are eligible for Part A of Original Medicare without having to pay a monthly premium. Part A is commonly referred to as hospital insurance.
- If your income as an individual for 2020 was $91,000 or less , you are eligible for Part B of Original Medicare for the standard monthly premium of $170.10 in 2022. The income thresholds and monthly premiums change annually for Part B, which is commonly referred to as medical insurance.
Can you get Medicare if youve worked less than 10 years?
Yes. But you may have to pay a monthly premium for Part A and, if you owe a Part A premium, you will be required to enroll in Part B as well.
The Centers for Medicare & Medicaid Services estimates that 99 percent of Medicare beneficiaries dont have to pay a Part A premium. Thats largely due to most Americans working at least 10 years before age 65, but there also are a few other ways to get Part A without a premium regardless of your work history.
Using Medicaid With Medicare Or Other Medical Insurance
If you have both Medicare and Medicaid, they work together for you. Medicare pays first, and Medicaid pays last.
Medicare has two parts: Medicare Part A and Medicare Part B
Medicare Part A:
- Pays for skilled nursing care and hospital services.
- Pays for most of your hospital expenses.
Medicaid will pay most of the hospital bills that Medicare Part A doesnt pay. You may be billed for a small amount, called co-insurance. You might also have to pay part of the deductible for inpatient hospital care.
Medicare Part B:
- Pays for visits to the doctor
- Pays for lab tests and X-rays.
Not everyone on Medicare has Part B. You have to pay a small amount each month. Medicaid will pay this monthly charge for you. Let your DHS county office know you have Medicare Part B so you wont be charged a Medicare premium. Medicaid also pays most of the charges that Medicare Part B will not pay. You may be billed for a small amount.
If you have health insurance and Medicaid:
Other times when Medicaid will not pay until someone else pays:
- If you are hurt in a car accident, Medicaid will not pay until your car insurance or the other drivers car insurance has paid or denied payment.
- If you are hurt on the job, Medicaid will not pay until workers comp has paid or denied payment.
- If you win a lawsuit because you got hurt or you get a cash settlement from such a lawsuit, you must use the money to pay your medical bills. Medicaid will only pay toward any amount of your medical bills that are left over.
How Old Do You Have To Be To Get Medicare
You become eligible for Medicare at age 65. This is earlier than retirement benefit eligibility through Social Security, which happens at age 66 or 67 for most people. However, if you’re younger than age 65, you can become eligible for Medicare if you have a disability or qualifying medical condition.
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Medicare Part A Eligibility
Many believe Medicare is free, but only Medicare Part A hospital coverage does not include a monthly premium â if you or your spouse qualify.
To be eligible, you or your spouse must have paid Medicare taxes for at least 40 quarters or ten years. If not, you will need to buy into Medicare Part A according to how many working quarters you paid the tax.
Your premium-free Medicare Part A eligibility status is available through your SSA.gov account. There, you can see how many eligible working quarters you paid Medicare taxesâ determining your Medicare Part A premium cost.
Medicare When Your Non
Youll need to make some decisions about Medicare when you become eligible, whether or not you continue working past age 65.
Either way, your spouse will need health insurance until he or she is also eligible for Medicare. Here are some of the options:
- Your spouse may continue coverage through your employer plan if you keep working and keep the employer coverage.
- Your employer may offer COBRA coverage for your spouse if you retire.
- Your spouse may choose to buy individual health insurance until he or she turns 65.
Your employer benefits manager can help you and your spouse understand your choices.
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Medicare Eligibility Requirements And Qualifications
Home / Original Medicare / Medicare Eligibility Requirements and Qualifications
Reaching Medicare eligibility can be confusing. Thus, understanding when you reach Medicare eligibility and what to do once you are eligible is essential. Below, you will learn everything you need to know about Medicare eligibility, requirements, and qualifications.
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Do Other Parts Of Medicare Cover Spouses
Can a non-working spouse also become eligible for other types of Medicare coverage?
The answer is yes. Enrolling in Medicare Part C , Medicare Part D or Medicare Supplement Insurance only requires enrollment in Medicare Part A and Part B in order to apply .
Once your spouse enrolls in both Medicare Part A and Part B, they may be eligible to enroll in other types of Medicare coverage.
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Social Security And Medicare
You do not have to be eligible for Social Security retirement benefits to receive Medicare, even if your eligibility is based on another persons work history. For instance, you might qualify for Medicare based on your spouses federal employment and payment of Medicare taxes instead of Social Security taxes. However, your Medicare eligibility might require that you meet Social Security disability requirements.
When Can You Sign Up For Medicare
Unless you qualify due to a disability, youre first eligible to sign up for Medicare during your Initial Enrollment Period . It lasts for 7 months, beginning 3 months before your 65th birthday. So, if you turn 65 in April, your IEP begins on January 1 and ends on July 31.
Unless you began collecting Railroad Retirement Board or Social Security benefits at least 4 months before turning 65, you have to apply for Medicare. You do this through the Social Security Administration by clicking here. You can also call 1-800-772-1213 . Please note that local Social Security offices are closed due to the COVID-19 pandemic. As of August 2020, there is no information on when offices will reopen.
During your Initial Enrollment Period, you can sign up for Medicare Parts A and B, join a prescription drug plan, or enroll in a Medicare Advantage plan.
If you choose to remain with your employer group plan AND your company employs 20 or more people, youll qualify for a Special Enrollment Period. This begins on the later of the following dates:
- The date your employment ends
- The date your employee coverage ends
There are dozens of ways to qualify for a Special Enrollment Period. Find the full list and guidelines on Medicare.gov here.
Our Find a Plan tool makes comparing Medicare plans easy. Just enter your location and coverage start date to review options in your area.
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Spouse Coverage And Social Security Work Credits
For a person or their spouse to qualify for Medicare, they will need to have built up enough Social Security credits throughout their employment history.
Medicare credits link to Social Security work credits. In 2020, a worker receives one work credit per $1,410 they earn. They can earn up to four credits annually.
Self-employed individuals also receive up to four annual work credits per $1,410 of net earnings.
Anyone born after 1929 must have a minimum of 40 work credits, or have 10 years worth of credits, to become eligible for Medicare. People born before this require fewer credits.
The number of qualifying credits for people who have a disability varies according to the age at which they developed the disability.
A person who develops a disability between 3142 years of age will require 20 work credits for Social Security disability benefits.
A person who develops a disability at age 62, will require the full 40 credits to qualify for Social Security disability benefits.
Not every type of employment counts toward Social Security work credits. If the spouse works for a local or state government that does not participate in Social Security, they will not earn credits.
Those with more than 10 years of service working on the railroads do not pay into Social Security. Instead, the Railroad Retirement Board benefits cover Medicare plans.
The RBB deducts Medicare payments from their employees paychecks, and railroad workers receive the same benefits as anyone else.
What Happens If One Of You Becomes Eligible For Medicare Before The Other
Unless you and your spouse were born in the same month of the same year, one of you will become eligible for Medicare before the other. If you both are covered by your employer health insurance, and one of you turns 65, youll have decisions to make about Medicare. In this case, it will depend on the employer and their rules around covered dependents of Medicare age. Some employers may require spouses who are eligible to get Medicare to do so at age 65 in order to remain on the employer plan.
You can learn more about your potential options by talking with your employer benefits administrator.
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Can You Get Medicare Advantage If You’ve Worked Less Than 10 Years
Yes, because if youre eligible for Original Medicare. then you also are eligible for Medicare Advantage.
With Original Medicare or Medicare Advantage, youre still responsible for premiums that you have to pay based on your limited work history. A Medicare Advantage plan, however, could help your bottom line in a couple of ways.
Medicare Advantage plans are offered by private insurance companies under the guidance of the federal Medicare program. They provide an alternative to Original Medicare, offering the same coverages provided by Parts A and B, and more. Medicare Advantage plans can offer things that Original Medicare cant like dental coverage for example that may save you money.
Some Medicare Advantage plans have a monthly premium. When you switch, you are still responsible for any Part A and B premiums that you owe. But most Americans have access to a Medicare Advantage plan with a $0 premium, and some Medicare Advantage plans help pay your Part B premium.
A GoHealth licensed insurance agent can help you determine if a Medicare Advantage plan would be beneficial for you and your finances.
Other Ways To Get Medicare Coverage
If you do not qualify on your own or through your spouses work record but are a U.S. citizen or have been a legal resident for at least five years, you can get full Medicare benefits at age 65 or older. You just have to buy into them by:
- Paying premiums for Part A, the hospital insurance. How much you would have to pay for Part A depends on how long youve worked. The longer you work, the more work credits you will earn. Work credits are earned based on your income the amount of income it takes to earn a credit changes each year. In 2022 you earn one work credit for every $1,510 in earnings, up to a maximum of four credits per year. If you have accrued fewer than 30 work credits, you pay the maximum premium $499 in 2022. If you have 30 to 39 credits, you pay less $274 a month in 2022. If you continue working until you gain 40 credits, you will no longer pay these premiums.
- Paying the same monthly premiums for Part B, which covers doctor visits and other outpatient services, as other enrollees pay. In 2022 the amount is $170.10 for individuals with a yearly income of $91,000 or less or those filing a joint tax return with $182,000 in income or less. Rates are higher for people with higher incomes.
- Paying the same monthly premium for Part D prescription drug coverage as others enrolled in the drug plan you choose.
You can enroll in Part B without buying Part A. But if you buy Part A, you also must enroll in Part B.
You can get Part D if youre enrolled in either A or B.
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Am I Eligible For Medicare Part A
Generally, youre eligible for Medicare Part A if youre 65 years old and have been a legal resident of the U.S. for at least five years. In fact, the government will automatically enroll you in Medicare Part A at no cost when you reach 65 as long as youre already collecting Social Security or Railroad Retirement benefits.
If youre already receiving Social Security or Railroad Retirement benefits, all you need to do is check your mail for your Medicare card, which should automatically arrive in the mail about three months prior to your 65th birthday . The card will arrive with the option to opt-out of Part B , but opting out of Part B is only a good idea if youre still working and have employer-sponsored coverage that provides the same or better coverage, or if your spouse is still working and you have coverage under their plan.
If youre not already receiving Social Security or Railroad Retirement benefits, youll need to enroll in Medicare during a seven-month open enrollment window that includes the three months before the month you turn 65, the month you turn 65, and the three following months. If you enroll before the month you turn 65, your benefits will start the month you turn 65 . If you enroll in the three months after you turn 65, your coverage could have a delayed effective date.
In addition to turning 65, people can become eligible for Medicare due to a disability , or due to end-stage renal disease or amyotrophic lateral sclerosis .
Does My Marital Status Affect My Medicare Payments
Your marital status can make a difference when it comes to your Medicare Part A premium.
Many people donât pay a monthly Part A premium. If you or your spouse worked at least 10 years while paying Medicare taxes, you and your spouse typically both get premium-free Medicare Part A.
What if your spouse is turning 65 and hasnât worked and paid taxes for 10 years â but you have? Even if you donât qualify for Medicare yet, but youâre at least 62, your work history can help your spouse get premium-free Medicare Part A. Hereâs an example.
- Sandy and Ken are a married couple. Sandy qualifies for Medicare before Ken does because Kenâs younger. Sandy worked seven years while paying Medicare taxes. Sheâd owe a monthly premium for Medicare Part A if it werenât for Kenâs work history.
- Ken is only 63, so he doesnât yet qualify for Medicare. But he has worked longer than 10 years while paying taxes. So, based on Kenâs work and tax history, Sandy qualifies for premium-free Part A because sheâs married to Ken.
You typically pay a monthly premium for Medicare Part B, regardless of your marital status. But if youâre married, and your combined income is more than a certain amount, you might have to pay a higher Part B premium. Learn about the adjustment amount known as the Part B IRMAA.
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How Do You Apply
You can apply online by using our Social Security Retirement/Medicare Benefit Application to apply for retirement, spouse’s, divorced spouse’s or Medicare benefits.
If you and your spouse apply online for retirement benefits at the same time, or if your spouse applies online after you start receiving benefits, we will check their eligibility for benefits as a spouse. If they are qualified, the online application will automatically include a request for spousal benefits on your record.
If your spouse applies for benefits, they need to be ready to supply the information we need to approve their application for these benefits:
Is Medicare Part B Based On Income
Medicare premiums are based on your modified adjusted gross income, or MAGI. If your MAGI for 2020 was less than or equal to the higher-income threshold $91,000 for an individual taxpayer, $182,000 for a married couple filing jointly you pay the standard Medicare Part B rate for 2022, which is $170.10 a month.
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Medicare And Employer Coverage
Medicare coverage includes two parts. Also known hospital insurance, Medicare Part A covers inpatient services received in a hospital or skilled nursing facility as well as hospice care. Medicare Part B is sometimes called medical insurance. It covers outpatient services, like doctor visits, lab work, and durable medical equipment . Together, Parts A and B make up Original Medicare.
You can get prescription drug coverage with a Medicare Part D plan. While joining a Part D plan is optional, if you delay enrollment and dont have creditable drug coverage elsewhere, you face lifelong late penalties. means a plan that is comparable to Medicare in terms of both price and coverage.
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