Approaching your 65th birthday brings up a lot of questions about retirement benefits and healthcare coverage. In this second installment of our “I’m Turning 65, Now What?” series, we’ll explore Medicare Part A and the “40 quarters” rule.

If you’ve worked and paid Medicare taxes for a total of 40 quarters — roughly 10 years — you can get Part A without paying a monthly premium. These quarters can be spread out over your working life; they don’t need to be in a row. But what happens if you don’t meet this requirement?

The good news is, you can still get Medicare Part A coverage. While Medicare has specific rules about work history, once you understand your options, obtaining coverage is simpler than you might think. 

Let’s explore your next steps with Medicare Part A. We’ll start by checking your work credits, then walk through each available path to coverage.

Your Medicare Part A work history: How to check where you stand

Want to know exactly where you stand with Medicare Part A work credits? Your mySocialSecurity account has the answer. This online tool shows your complete earnings record and the number of credits you’ve earned over your working years.

Creating your account is straightforward. Visit ssa.gov and click “Sign in/Create account.” You’ll need your Social Security number, current U.S. mailing address, and a valid email address. The setup process takes about 10 minutes.

Once you’re logged in, look for your earnings record. This shows your Medicare Part A work history, including every year you’ve worked and paid Medicare taxes. Each year is broken down into quarters, and you’ll see exactly how many of those important 40 quarters you’ve earned. Remember, any quarter you earned enough and paid Medicare taxes counts toward your total, no matter how long ago it was.

How to qualify for Medicare through your spouse’s work history

Not enough work credits for Medicare, or wondering if you can get Medicare if you’ve never worked? Take a look at your spouse’s work history. Many people qualify for premium-free Part A through their spouse without realizing it. Here’s when this works:

• You’ve been married for at least a year
• You were married for 10+ years before divorcing
• You’re widowed after being married for at least nine months

There are a few timing details to be aware of. For instance, your spouse must be at least 62, and you must be 65 or older. If divorced, you can still use your former spouse’s work credits if you haven’t remarried. If you’re widowed, you keep this option even if you remarried after turning 60.

And remember: Using your spouse’s work credits won’t affect their Medicare benefits at all. Their 40 quarters can work for both of you.

Buying into Medicare Part A: Your complete guide to premium costs

Part A isn’t free for everyone, but that doesn’t mean you can’t get coverage. The cost to buy into Part A in 2025 depends on how long you worked. If you have between 30 and 39 quarters of work credits, you’ll pay $285 each month. If you have fewer than 30 quarters of coverage, the full premium is $518 monthly.

Most importantly: You cannot buy into Part A without also enrolling in Part B. This is a firm Medicare requirement with no exceptions. 

In 2025, most people paid $185 monthly for Part B. While these premiums might feel steep, remember what you’re protecting yourself against. A single hospital stay without Medicare could cost years of premiums.

Some good news about buying Parts A and B together: you get the same solid coverage as people who get Part A premium-free. You can still add a Medicare Advantage plan or Medigap policy, and you get the same access to Medicare’s network of doctors and hospitals.

Still working? When to consider delaying Medicare Part A

Having employer health coverage opens up strategic timing options for Medicare Part A. Some people with workplace insurance choose to delay enrollment, especially if they need to buy Part A and Part B together. This strategy might make sense if your employer coverage costs less than Medicare premiums.

Before deciding to wait, check with your benefits administrator. Workplace plans vary in how they work with Medicare. Some require you to take Medicare at 65, while others let you choose. The size of your company and your role in the business can affect these rules.

Watch your timing when you’re ready to leave your job. You’ll have eight months after your workplace coverage ends to sign up for Medicare. Miss this window, and you could face coverage gaps and late penalties.

Not sure about your next steps? Our agents know how to help you transition smoothly, and find coverage that fits your needs.