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  • Writer's pictureJanelle Doll

How Do You Qualify for Medicare?

Medicare is a national program that is supposed to benefit all, but some may feel like the exception to the rule. With some proper planning, it can be a “benefit” for everyone!


First, to qualify for Premium Free Medicare Part A (Hospital Coverage):

  • You must have accumulated 40 credits (10 years of work) by working and paying into Social Security taxes (FICA taxes)

  • You must be 65

If you have not paid FICA taxes and you will have to pay a premium for Medicare Part A. Keep in mind if you waive your Part A coverage when you first become eligible, you MAY have a penalty later.


HICAP encourages you to create an account and view your eligibility credits at www.ssa.gov. Credits are based on your total wages and self-employment income for the year. In 2021, you are eligible to earn one credit for every $1,470 in earnings each year. You must earn $5,880 to get the maximum of four credits for the year.


If you do not have at least 40 credits, but your spouse does, you may be eligible for premium free Medicare Part A based on your spouse’s work history when you turn 65 if:

  • You are currently married and your spouse is eligible for Social Security benefits. You must have been married for at least one year before applying.

  • You are divorced and your former spouse is eligible for Social Security benefits. You must have been married for at least 10 years, and you must now be single.

  • You are widowed and married for at least nine months before your spouse died. You must be single.

Be aware that there are some exceptions to these eligibility rules and to confirm your individual eligibility it is advised to contact the Social Security Administration at 800-772-1213.


Your Part B (Medical Coverage) has a standard premium of $148.50 in 2021; however, you may pay more depending on your current income. You may review this rate chart at www.medicare.gov.


Still have questions, contact your local HICAP and ask to schedule a free, unbiased, and confidential appointment with a registered counselor to review your eligibility and Medicare benefits. HICAP is currently scheduling both phone and virtual appointments Monday through Friday, 8am -5pm. Please give us a call at (559) 224-9117 or (800) 434-0222, we are here to help!

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