Here's the short answer. Work you did in another country, such as Korea, does not count toward free Medicare Part A. Social Security has agreements with other countries, called totalization agreements. They can count your foreign credits toward U.S. retirement, disability, or survivor benefits. But Social Security says the agreements do not cover Medicare benefits, so it cannot count those credits to qualify you for free Medicare hospital insurance. Free Part A generally needs about 10 years of U.S. work, or 40 quarters, by you or your spouse.
What a totalization agreement does
These agreements have two main purposes. First, they stop people from paying Social Security taxes to two countries on the same earnings. Second, they help workers who split their careers between the United States and another country.
The United States has agreements with about 30 countries, including South Korea. The Korea agreement took effect on April 1, 2001.
For the United States, the agreements cover Social Security taxes, Medicare taxes, and retirement, disability, and survivors benefits. They do not cover benefits under the Medicare program. That one sentence explains most of the confusion.
Why foreign credits do not count for Part A
Social Security says it cannot count your credits in an agreement country to establish entitlement to free Medicare hospital insurance. Part A is the hospital part of Medicare. Premium-free Part A depends on U.S. work and U.S. Medicare taxes. Medicare says most people get it because they or a spouse paid Medicare taxes long enough while working, generally at least 10 years.
| What you want | Can foreign credits help? |
|---|---|
| U.S. Social Security retirement, disability, or survivor benefits | Sometimes. Social Security may count them if you meet the agreement's rules. |
| Free (premium-free) Medicare Part A | No. Foreign credits cannot be counted for this. |
| Buying Part A or Part B | Not needed. You use other rules, such as age and residency. |
The Korea example
Say you worked for years under Korea's National Pension system. You then move to the U.S. and work here for a few years. For Social Security retirement benefits, the agreement can help in a narrow way. To have your Korean credits counted, you must have earned at least six U.S. credits, generally one and one-half years of work. If you already have enough U.S. credits, the U.S. cannot count your Korean credits.
The U.S. needs 10 years of work, or 40 credits, for retirement benefits if you were born in 1929 or later. In 2026, you earn one credit for each $1,890 of earnings, up to four credits a year. None of this changes the Medicare rule above. Your Korean credits may help your Social Security pension, but they do not make Part A free.
The same logic applies to every agreement country, not just Korea.
If you don't have 40 quarters
You may still be able to get Medicare. These are the main routes:
- A spouse's work. Premium-free Part A can be based on your own earnings or on those of a spouse, parent, or child. Only U.S. work counts toward this, so your spouse's U.S. record matters. See Medicare for Couples and using a spouse's work record.
- U.S. government work. Time in a government job where you paid Medicare taxes can count.
- Buy Part A. If you don't qualify for free Part A, you may be able to buy it. In 2026 the price is $311 or $565 a month, depending on how long you or your spouse worked and paid Medicare taxes. To buy Part A, you must also sign up for Part B.
- Buy Part B only. If you aren't eligible for free Part A, you can buy Part B without Part A. You must be 65 or older, and either a U.S. citizen or a lawfully admitted noncitizen who has lived in the U.S. for at least five years.
If you buy Part A late, the premium can go up 10%, for twice as many years as you could have signed up but didn't. See late enrollment penalties.
A short action list
- Count your U.S. work. Check your U.S. earnings record through your my Social Security account.
- Include your spouse. Check their U.S. record too.
- Plan your sign-up. If you must buy coverage, sign up in your Initial Enrollment Period to avoid penalties. See Turning 65.
- Call Social Security. The number is 1-800-772-1213. Ask about your Medicare options and your credits.
- Ask your SHIP for free help. Find yours in the SHIP directory. If you need language help, see interpreter rights.
Common questions
Do my Korean work credits count toward the 40 quarters for Part A?
No. Social Security says the agreement does not cover Medicare benefits, so it cannot count credits earned in an agreement country to qualify you for free Medicare hospital insurance.
Can Korean credits help with Social Security retirement benefits?
Sometimes. You need at least six U.S. credits for Korean credits to be counted, and the U.S. cannot count them if you already have enough U.S. credits.
Can I still get Medicare without 40 quarters?
Yes, in many cases. You may qualify through a spouse's U.S. work, or you may buy Part A and Part B. The rules on age and residency apply.
Does my spouse's work in the U.S. help me?
Yes. Premium-free Part A can be based on your own earnings or on those of a spouse, parent, or child.
Official sources
- SSA: Totalization agreement descriptions
- SSA: Totalization agreement with Korea
- SSA: U.S. international Social Security agreements
- SSA: How You Earn Credits
- SSA: Medicare booklet
- Medicare.gov: Costs