Key Takeaways

  • Qualifying for premium-free Medicare Part A depends on having worked and paid Medicare taxes for at least 40 quarters (10 years).
  • Without 40 quarters of work, you might still be eligible for premium-free Part A through a spouse’s or parent’s work history, specific medical conditions, or Social Security disability benefits.
  • If you don’t qualify for premium-free Part A, you’ll pay a monthly premium, which varies based on how many quarters you have worked. Part A premiums typically increase annually.

Part A covers inpatient hospital care, and most people are eligible for premium-free Part A based on individual work history, a spouse’s work history, or an eligible medical condition.

If not, you will pay a premium based on how many quarters you have worked during your lifetime.

One quarter is equal to a 3-month period of time. There are 4 quarters in every calendar year.

Medicare tracks how many quarters of work you accumulate throughout your life. Each quarter of work counts as 1 credit.

To earn a qualifying quarter of work, or 1 credit, you must meet a minimum earnings threshold. The earnings threshold is updated annually based on inflation and wage growth.

In 2025, you must make at least $1,810 in a calendar quarter to earn 1 credit. You can earn up to 4 credits each year.

If you make more than the minimum earnings threshold in a calendar quarter, you may qualify for additional credits. For example, if you meet the annual earnings threshold, which is $7,240 in 2025, in a single calendar quarter, you earn the annual allotment of 4 credits in just one quarter of work.

The time it takes to earn 40 qualifying credits depends on your employment history.

If you work continuously and meet the earnings requirement every quarter, you can accumulate 40 credits in 10 years.

Breaks in employment or periods where your earnings fall short of the required threshold can extend this timeline.

It’s important to understand that you cannot earn more than 4 credits per calendar year, regardless of your income or the number of months you work.

If you don’t have 40 credits, depending on your circumstances, you may still be eligible for premium-free Part A or be able to purchase it.

Eligibility based on another person’s work history

You may be eligible for premium-free Part A based on the earnings of a:

  • current or former spouse
  • parent
  • child

Eligibility based on an underlying condition or disability

You may be eligible for premium-free Part A if you:

  • have amyotrophic lateral sclerosis (ALS)
  • have end stage renal disease
  • receive regular dialysis treatments
  • received a kidney transplant
  • receive Social Security disability benefits

Paying out of pocket

In 2025, if you have between 30 and 39 credits, you’ll pay $285 per month for your Part A premium.

If you have fewer than 30 credits, you’ll pay $518 per month.

Each quarter you work over your lifetime equates to 1 credit toward the 40 required for premium-free Medicare Part A coverage.

Often referred to as “40 quarters,” the 40-quarter requirement only applies to premium-free Part A.

Other parts of Medicare have a monthly premium regardless of how many quarters you have worked throughout your lifetime.