Can I Get Medicare if I've Never Worked?

by Gail Sessoms ; Updated April 24, 2018
An older couple at the doctor's.

You can receive Medicare health insurance benefits even if you have never worked. As with Social Security retirement benefits, many people qualify for Medicare based on their work history and payment of payroll taxes. However, if you are a U.S. citizen or permanent resident who is age 65 or older, under age 65 with a disability or have permanent kidney failure, you can receive Medicare benefits through means other than your own employment history.

Spouse or Dependent Parent

You can qualify after age 65 to receive free Medicare Part A, Hospital Insurance, based on the eligibility of your spouse, whether living or deceased, even if you are divorced from the person. Medicare’s Hospital Insurance covers inpatient care at hospitals and other health care facilities. You might be Medicare-eligible if your spouse is eligible for or received Railroad Retirement or Social Security retirement benefits, or if you receive those retirement benefits based on your spouse’s employment or eligibility. You also might qualify for Medicare based on your spouse’s federal employment and payment of Medicaid taxes, or if you are the dependent parent of a deceased child who was fully insured under Medicare.

Disability Eligibility

Even if you have not worked, certain disabilities can qualify you to receive Medicare before age 65. You can qualify for free Medicare Part A if you have permanent kidney failure, amyotrophic lateral sclerosis or a disability, as determined by the Social Security disability program. You also can qualify if you are a child or widowed spouse of someone who has paid Medicare taxes through a government job. A widowed spouse, including one divorced from the qualifying worker, must be 50 years of age or older to qualify.

Payment of Monthly Premium

If you do not qualify for free Medicare Part A, Hospital Insurance, based on the eligibility of a spouse or as a dependent parent, you can pay a monthly premium to receive Medicare Part A once you are age 65 or older. Some states have programs that help low-income people pay for Medicare Part A premiums and out-of-pocket costs. Contact your local social service office or your state’s division of medical assistance.

Medicare Parts B and D

If you qualify for free Medicare Part A, you may enroll in and pay an income-based monthly premium for Medicare Part B, Medical Insurance, which covers outpatient care from doctors and other health care providers. If you are not eligible for free Medicare Part A, you can still enroll in Medicare Part B and pay a monthly premium for the benefit if you are age 65 or older and a U.S. citizen or legal non-citizen with U.S. residency of five years or more . You can enroll voluntarily in Medicare Part D, Prescription Drug Plan, if you receive benefits through Medicare Part A or B.

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 person’s work history. For instance, you might qualify for Medicare based on your spouse’s 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.

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About the Author

Gail Sessoms, a grant writer and nonprofit consultant, writes about nonprofit, small business and personal finance issues. She volunteers as a court-appointed child advocate, has a background in social services and writes about issues important to families. Sessoms holds a Bachelor of Arts degree in liberal studies.

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