‘Working’ 10-year rule when applying for Medicare

on Apr 10, 2025

In February, my husband, James, was laid off and decided to apply for an individual health insurance plan because he is 62 and could not apply for Medicare. I turned 65 in March and am having a stressful financial issue after enrolling in Medicare. Now my Medicare is costing me $518 for Medicare Part A and $185 for Medicare Part B, totaling $703 a month! I am completely shocked because my sister is only paying $185.

I married James 32 years ago and haven’t worked much, because I stayed home to take care of our 3 children. I called the 800-number for Social Security, and the representative said that I had not worked enough time to have Medicare Part A at no cost and that this is my issue.

Please explain what I should do to correct my Medicare problem. Thank you, Toni!

-- Wendy from Rosenberg, Texas

Hi Wendy:

Most Americans are not aware that they must work a certain amount of time, paying employment taxes, to receive premium-free Medicare Part A. This is most likely the cause of your problem. The Toni Says Medicare team helps resolve this issue quite often.

On the medicare.gov website, it states that to qualify for Medicare Part A at no cost you must have worked and paid Social Security and Medicare taxes from your payroll checks for 10 years or 40 quarters. For 2025, if you have paid Medicare taxes for 30-39 quarters, then the standard Part A premium is $285 each month. If a person paid Medicare taxes for less than 30 quarters -- the level at which you qualified, Wendy -- then the premium for Medicare Part A is $518 per month. The extra Part A premium amounts change on Jan. 1 each year, just like Medicare Part B premiums change.

However, those who do not qualify for premium-free Medicare Part A, but who have been married to a current or former spouse for at least 10 years who has met the 10-year requirement, should apply for Medicare under their working spouse’s Social Security number. Wendy, this is your issue, since you have been married for 32 years to James, and you should have applied for Medicare under James’s Social Security number.

My advice to you would be to contact your local Social Security office, since that is the government office which enrolls Americans in Medicare. Isn’t it amazing that it is not Medicare that enrolls Americans into Medicare, but Social Security? Wendy, visit Social Security at: www.ssa.gov/manage-benefits/make-an-appointment.

You need to schedule an in-person appointment with a local Social Security representative to be sure that your Medicare is processed properly. Ask them for help in appealing the Medicare Part A premium of $518, because you have been a stay-at-home spouse with a husband who has worked enough quarters to qualify for premium-free Medicare Part A.

Social Security will look over your husband, James’s, Social Security accounts to verify with the IRS that he has enough quarters to qualify for premium-free Medicare Part A. Be prepared to provide a certified marriage license showing that you and James are married. You will have to provide the original certified marriage license (not a copy) to Social Security.

Those who did not work for 10 years or more to qualify and never married (or lived with someone as a domestic partner) and do not have a certified marriage license, will have to pay for their Medicare Part A premium. And if their spouse/domestic partner did not work enough quarters, they both will have to pay for their Medicare Part A premiums.

Readers don’t forget the “working 10-year rule” when enrolling in Medicare. What you don’t know about enrolling in Medicare WILL hurt you! (Chapter 1 of Toni’s Medicare Survival Guide Advanced edition can help you avoid problems like Wendy’s.)

- - -

Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. The “Medicare Survival Guide Advanced” edition and her new “Confused about Medicare” video series are available at www.tonisays.com.