Here's the short version. Most people pay nothing for Medicare Part A because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years. That spouse can be your current spouse, a former spouse, or a spouse who has died. The marriage rules are the same ones Social Security uses for spouse benefits. For a former spouse, you must have been married at least 10 years right before the divorce became final, and you must not be married now. For a spouse who has died, you generally must have been married at least 9 months before the death. For a current spouse, the marriage must have lasted at least 1 year. Your own Medicare still starts on your own timeline, at your own age 65. The rest of this page walks through each situation.
Why a spouse's work record matters
Medicare Part A is the hospital part of Medicare. Part A is free if you worked and paid Medicare taxes for at least 10 years. You may also be eligible because of your current or former spouse's work. That is the whole point of this page: if your own work history falls short, a spouse's record can fill the gap.
If you don't qualify for premium-free Part A, you might be able to buy it. In 2026 the price is either $311 or $565 each month, depending on how long you or your spouse worked and paid Medicare taxes. You also have to sign up for Part B to buy Part A. So qualifying on a spouse's record can save you thousands of dollars a year.
Part B works the same for everyone. Anyone who is eligible for Part A at no cost can enroll in Part B by paying the monthly premium. Our Part A guide and Part B guide explain what each part covers.
Who can get Part A at no cost at 65
Social Security's own booklet lists who gets Part A at no cost at age 65. You qualify if one of these applies:
- You receive, or are eligible to receive, benefits from Social Security or the Railroad Retirement Board.
- Your spouse, living or deceased, including a divorced spouse, receives or is eligible to receive Social Security or Railroad Retirement benefits.
- You or your spouse worked long enough in a government job through which you paid Medicare taxes.
- You are the dependent parent of a fully insured child who has died.
Notice the words "eligible to receive." Your spouse does not have to be collecting a check yet. But Social Security must find that your spouse could collect one. Whether that is true depends on your spouse's age and work record. Social Security can check this for you.
Through a current spouse
This is the simplest case. You must be legally married, and the marriage must have lasted at least 1 year. Your spouse must be getting Social Security or Railroad Retirement benefits, or be eligible to get them.
Age can be the catch. Medicare is individual, so you become eligible at your own 65th birthday. If your spouse is much younger and is not yet eligible for Social Security, ask Social Security what your options are in the meantime. Our Medicare for couples page explains how two different timelines play out.
Not legally married? Domestic partners are treated differently by different rules. Confirm with Social Security before you count on a partner's record. See Edge Cases & Complications.
Through an ex-spouse: the 10-year rule
A divorced spouse counts. Social Security's rules for a divorced spouse say you must meet all of these:
- You were validly married to your former spouse.
- The marriage lasted at least 10 years right before the divorce became final.
- You are not married now.
- You apply.
- You are age 62 or older. (For Medicare, you'll be 65 or older anyway.)
Your ex does not have to be collecting benefits. If your former spouse has not filed yet, you can still qualify as long as your ex is at least 62 and you have been divorced for at least 2 years.
Two details people ask about. First, you apply through Social Security on your own. Social Security says you "may qualify for benefits as an ex-spouse on his or her record if you are not currently married." Second, if you married the same person more than once, Social Security can count those marriages as one 10-year period if you remarried no later than the calendar year after the year the divorce became final.
Remarriage matters. If you are married to someone else now, you would look to your current spouse's record instead.
Through a spouse who has died: the 9-month rule
If your spouse has died, you may be eligible for Medicare based on the work history of the family member who died. Social Security's survivor rules for a spouse say you may be eligible if you:
- Are age 60 or older, or age 50 to 59 if you have a disability.
- Were married for at least 9 months before your spouse's death.
- Didn't remarry before age 60 (age 50 if you have a disability).
There are exceptions to the 9-month rule. It does not apply if the death was accidental, if your spouse died in the line of duty while on active military duty, if you had been married to the same person before for at least 9 months, or if you and your spouse were the natural parents of a child. Remarrying after age 60 does not take away your survivor eligibility.
Surviving divorced spouse. If you were divorced from the person who died, the 10-year rule applies instead. You must have been married for at least 10 years right before the divorce became final.
Before 65: disability and kidney failure
A spouse's record can also open the door before age 65. Social Security's booklet says you can get Part A at no cost before 65 if you are the child or surviving spouse age 50 or older, including a divorced surviving spouse, of a worker who worked long enough under Social Security or in a Medicare-covered government job, and you meet the requirements of the disability program.
For permanent kidney failure, you can qualify as the child or spouse, including a divorced spouse, of a worker, living or deceased, who worked long enough under Social Security or the railroad system. Our guides to Medicare under 65 and Medicare for kidney failure cover those paths.
Social Security also asks you to contact them if you are a surviving spouse with a qualifying disability between age 50 and 65 who hasn't applied for disability benefits because you already get another kind of Social Security benefit.
What a spouse's record does not change
Medicare is individual. There is no family plan and no spouse coverage. Each of you becomes eligible on your own 65th birthday and gets your own 7-month sign-up window. Social Security suggests you sign up for Medicare three months before your 65th birthday. If you don't enroll in Part B when you're first eligible, you may pay a late enrollment penalty for as long as you have Part B. That deadline is yours, no matter whose work record you use. See Turning 65: Start Here and Enrollment & Deadlines.
How to apply
- Sign up through Social Security. You sign up for Part A and Part B through Social Security, not Medicare. If you're 65 or older, you can enroll online for Parts A and B, or Part A only. Start at ssa.gov/medicare/sign-up.
- Or call. Call Social Security at 1-800-772-1213 and say you want to sign up for Medicare. TTY users can call 1-800-325-0778.
- Have your information ready. Social Security will ask for your Social Security number, where you were born, and the start and end dates of any group health plan you have had.
- Tell them about the marriage. Social Security uses the information you give about a prior marriage, along with your other answers, to see if you can get benefits on that spouse's record. Have the marriage date, and the divorce date or date of death, at hand.
- Railroad workers. If you or your spouse worked for a railroad, contact the Railroad Retirement Board at 1-877-772-5772.
If you don't qualify on anyone's record
You still have options. You may be able to buy Part A by paying a monthly premium, usually only during set enrollment periods. You can also buy Part B without buying Part A if you are 65 or older and a U.S. citizen, or a lawfully admitted noncitizen who has lived in the United States for at least five years. If you can't afford the premiums, your state's Medicare Savings Programs may pay them for people with limited income and resources. See Getting Help Paying and Medicare for immigrants.
Common questions
Do I need my ex-spouse's permission to use their record?
You apply on your own through Social Security. Social Security says you may qualify for benefits as an ex-spouse on your former spouse's record if you are not currently married. Your ex does not even have to be collecting benefits yet, as long as your ex is at least 62 and the divorce is at least 2 years old.
We were married 9 years. Can I use my ex's record?
For a divorced spouse, the marriage must have lasted at least 10 years right before the divorce became final. If you married the same person twice, Social Security may count both marriages as one if you remarried no later than the calendar year after the year the divorce became final. Ask Social Security to review your exact dates.
I remarried after my spouse died. Do I lose the survivor path?
It depends on when you remarried. The survivor rules require that you didn't remarry before age 60 (age 50 if you have a disability). Remarriage after 60 does not count against you. And if you are married now, your current spouse's record may qualify you too.
My spouse is 58 and I'm turning 65. Can I use their record now?
Your spouse must receive, or be eligible to receive, Social Security or Railroad Retirement benefits for you to get Part A at no cost on their record. Ask Social Security whether your spouse counts as eligible yet. If not, ask what your options are for now, including buying Part A. Don't skip Part B while you wait, because the late enrollment penalty lasts as long as you have Part B.
Does using a spouse's record change what I pay for Part B?
No. Part B is a separate monthly premium that everyone pays, and higher-income people pay more. The spouse's record only affects whether your Part A is free. See Understanding Your Costs.
Related pages
- Planning for Two: Medicare for Couples — two timelines, two premiums, and what happens when one of you retires first.
- Medicare Part A — what hospital insurance covers and who pays a premium.
- Turning 65: Start Here — your enrollment window and the steps in order.
- Edge Cases & Complications — including unmarried partners and other spouse-based rules.
- Medicare for Immigrants and Green Card Holders — buying in when no work record qualifies you.
Official sources: Social Security: Medicare (Publication 05-10043), SSA: Who can get Family benefits, SSA: Who can get Survivor benefits, 20 CFR 404.331 (divorced spouse), 20 CFR 404.335 (widow or widower), and Medicare.gov: Costs.