Medicare determines the cost of Part A premiums based on the number of quarters you worked and paid Medicare taxes before beginning to receive benefits.
Part A is hospital insurance. Most people are eligible for premium-free Part A based on individual work history, a spouse’s work history, or an eligible medical condition.
A quarter is 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, you must meet a minimum earnings threshold. The earnings threshold is updated annually based on inflation and wage growth.
In 2024, you must make at least $1,730 in a calendar quarter to earn 1 qualifying quarter of work. You can earn up to 4 quarters of work each year.
If you make more than the minimum earnings threshold in a calendar quarter, you may qualify for additional quarters of work.
For example, if you meet the annual earnings threshold — $6,920 in 2024 — in a calendar quarter, you earn the annual allotment of 4 quarters of work in a single quarter.
The time it takes to earn 40 qualifying quarters of work depends on your employment history.
If you work continuously and meet the earnings requirement every quarter, you can accumulate 40 qualifying quarters 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 quarters of work per calendar year, regardless of how much you make or how many months of the year you work.
If you don’t have 40 quarters of work, you may have other options for enrolling in Part A. Depending on your circumstances, you may still be eligible for premium-free Part A or able to buy it.
Eligibility based on another person’s work history
You may be eligible for premium-free Part A based on the earnings of your:
- 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
If you have 30 to 39 qualifying quarters of work, you’ll pay $278 per month for your Part A premium. If you have fewer than 30 quarters, you’ll pay $505 per month.
The 40 quarters 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.