• 如果您从未工作，那么您仍然有资格premium-free Medicare Part A. This is based on your spouse’s work history or if you have certain medical conditions or disabilities.
  • It’s also possible to get Medicare coverage if you pay a monthly Part A premium.

大多数医疗保险受益人不为Medicare A部分（医院承保范围）支付保费。这是因为，在您工作时，您的收入征税一定时间长，并付给了《联邦保险捐款法》，该法案为医疗保险提供了资金。

In general, Medicare is available premium-free if you’ve worked a total of 40 quarters (10 years or 40 work credits). But can you still get Medicare if you haven’t worked for that length of time during your life?

The short answer is yes. You can get free Medicare Part A through your spouse or if you have certain medical conditions or disabilities. You can also choose to pay for Part A if you don’t qualify.

In this article, we’ll discuss how you can get Part A with or without a monthly premium, how your work history affects eligibility for other parts of Medicare, and more.

Medicare is health insurance that’s provided through the U.S. government. It’s available once you turn 65 years old or if you:

  • receive Social Security disability benefits for at least 2 years
  • receive disability pension benefits from the Railroad Retirement Board
  • have amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease
  • have end stage renal disease (ESRD), or kidney failure

Most people don’t have to pay monthly premiums forMedicare Part A(hospital coverage) because they’ve paid a portion of their earnings into the system for at least 40 quarters throughout their working years.

You can also qualify for premium-free Medicare Part A through your spouse or parent. You may also enroll in and pay for Part A coverage yourself.

如果你有n’t worked for the required length of time, there are two main ways you can still qualify for Medicare Part A without a monthly premium.

Through your spouse

When you turn 65 years old, you may be eligible for Medicare Part A if你的配偶已经工作了至少40个季度。

如果您目前已婚：

  • 你的配偶must be eligible for Social Security disability or retirement benefits
  • you must have been married for at least 1 year

如果你离婚：

  • 您以前的配偶必须符合社会保障残疾或退休福利的资格
  • you must have been married at least 10 years

If you’re a widow or widower:

  • 您的配偶一定有资格获得社会保障残疾或退休福利
  • you must have been married for at least 9 months before your spouse passed away
  • 您当前必须单身

Medical conditions and disabilities

如果你有certain disabilities, you may be eligible for premium-free Medicare Part A benefits even if you’re under 65 years old.

社会保障残疾保险（SSDI）收件人

如果你有a disability and have beenreceiving SSDI benefitsfor at least 24 months (2 years), you will automatically be enrolled in premium-free Medicare at the beginning of the 25th month.

ESRD

If your doctor has diagnosed you withESRD(kidney failure) and you’ve received a肾脏移植or you’re ondialysis，如果适用以下标准之一，您有资格获得Medicare福利：

  • you qualify for Social Security retirement benefits
  • 您有资格获得铁路退休委员会福利
  • 你的配偶or parent (living or deceased) worked long enough to be eligible for Social Security retirement benefits

当您有资格获得Medicare福利时，取决于您是在家中还是在治疗设施中接受透析：

  • 如果你接受透析in your home, you can apply for Medicare the first day you begin your dialysis program. You need to be sure to apply before the third month of treatment.
  • If you receive dialysis in a treatment facility, you can apply for Medicare on the first day of the fourth month of your treatment.

If you’re scheduled to receive a kidney transplant, you can apply for Medicare on the first day of the month you’re admitted to the hospital to start preparing for the transplant. But if your transplant is delayed, your Medicare benefits won’t start until 2 months before the month your transplant takes place.

ALS

如果你有ALS，您会自动有资格获得无优质的Medicare A部分，该部分将在您的SSDI福利开始后立即开始。

当您注册SSDI时，您将有5个月的等待期限，然后才能开始福利。等待期结束后，您的Medicare和SSDI福利在同一个月开始。

If you don’t have enough work history or meet the criteria discussed above to get premium-free Medicare Part A, you can still get coverage by paying the monthly premiums on your own.

To apply, you must be 65 years old and a U.S. citizen or a lawfully admitted noncitizen who has lived in the United States for 5 years or more.

If you buy Medicare Part A coverage, you must also enroll in Medicare Part B and pay those monthly premiums.

The 2022 monthly premium forPart A coveragecan be up to$ 499per month. The monthly premium forMedicare Part B coverageis typically$ 170.10, but you may have to pay a higher Part B premium if you have ahigher income level.

Part A is the only part of Medicare that requires a specific amount of work history. You can enroll in Medicare parts B, C, and D without a work history.

Medicare Part B

Medicare Part B涵盖门诊医疗服务，例如医生的访问。只要您至少65岁，就可以注册Medicare的工作历史记录要求。

注册Medicare B部分后，您将每月支付$ 170.10in 2022. Your premium may be more if your income is higher.

Medicare Part C (Medicare Advantage)

Medicare Advantageis a private insurance option that offers the same basic benefits as original Medicare (Part A and Part B), plus additional benefits likevision和dental关心。您必须有资格获得原始Medicare，才有资格获得Medicare Advantage计划。

Although all Medicare Advantage plans must provide the same basic coverage as original Medicare, their costs and added benefits vary based on the insurance provider and the state regulations where you live.

Medicare Part D

Medicare Part D提供处方药福利。虽然这个计划is optional, Medicare requires you to have sufficient prescription drug coverage within 63 days of the date you become eligible for Medicare. This applies whether you get that coverage through Medicare, your employer, or another source.

If you don’t enroll in a Part D plan when you’re first eligible and you later decide to enroll, you could face a permanent延迟入学费. The national base beneficiary premium for Part D plans is$ 33.37per month in 2022.

Medigap

Medigap政策是私人保险公司提供的可选补充政策。它们可以帮助您支付医疗保险的支付，共同保险和自付额。要注册12个可用的Medigap计划之一，您必须已经注册了原始Medicare。

The costs of Medigap policies vary because each plan covers different medical fees. Some Medigap policies cap the amount of out-of-pocket expenses you will have to spend each year, while others have no cap.

Insurance companies don’t have to sell you a Medigap policy, so your best bet is to enroll in a Medigap plan during your initial enrollment period if you think you may need this type of extra coverage.

If you need help paying your Medicare costs, there are federal and state programs that can assist you, including:

Medicare eligibility can be complicated, so if you still have questions, you can contact Medicare directly by calling 800-MEDICARE. You can also get impartial guidance through your local国家健康保险援助计划（船）.

  • Most people who are eligible for Medicare Part A coverage won’t have to pay a monthly premium because they paid Social Security taxes throughout their working years.
  • 如果您没有工作40个季度（大约10年），则如果您有某些障碍或根据您的配偶或父母的工作历史，您仍然可以将Medicare Part提供免费保费。
  • Even if you’re not eligible for premium-free Medicare Part A, you may still be able to get coverage if you pay the monthly premiums yourself.
  • 如果您不符合条件，那么重要的截止日期和罚款可能会适用，因此，如果您不确定哪个入学期限适用于您，则可以寻求帮助是个好主意。

Read this article in Spanish