Can I get Medicare without 40 work credits?

Before you resign yourself to paying for Part A, check your spouse’s record. You may qualify for premium-free Part A on the work history of a current spouse (if they are at least 62), an ex-spouse from a marriage that lasted 10 or more years, or a deceased spouse, depending on your situation. Many people who “don’t have enough credits” on their own record qualify free this way, including stay-at-home spouses and later-in-life immigrants married to long-time U.S. workers.

What Part A costs in 2026 by work credits

A work credit is a quarter of Social Security-covered earnings; you can earn up to 4 per year, so 40 credits is roughly 10 years of work.

Everything else about Part A works the same either way, including the $1,736 inpatient hospital deductible per benefit period for 2026. Part B has no work requirement at all: for 2026 anyone eligible pays the standard $202.90 per month (more at higher incomes), whether they have zero credits or forty.

Two things to know if you’ll pay for Part A

First, buying Part A generally requires you to also enroll in Part B, and legal permanent residents typically need 5 years of continuous U.S. residency before they can buy in.

Second, premium Part A has its own late enrollment penalty: a 10% surcharge on the premium, paid for twice the number of years you delayed. Example: if you were eligible for premium Part A in 2022, waited 2 full years, and enrolled for 2026, you would pay $311 plus 10% (about $342.10 per month at 2026 rates) for 4 years, then drop back to the regular premium.

If the premium is out of reach

Depending on your income and assets, state Medicare Savings Programs may pay the Part A and Part B premiums for you, and some people close to 40 credits simply keep working. Credits earned after 65 still count, so a person at 36 credits can work one more year, reach 40, and stop paying the Part A premium at that point.

Here’s what I tell clients in this spot: pull your Social Security earnings record first. Credit counts are sometimes wrong or missing years, and fixing the record can be worth thousands of dollars a year.