Turning 65 does not automatically mean you get free Medicare Part A.
For most people, Part A, which covers hospital care, comes with no monthly premium because they or their spouse paid Medicare taxes while working for at least 10 years.
But if you moved to the U.S. later in life, you may not have enough U.S. work credits to qualify for premium-free Part A.
That does not necessarily mean you cannot get Medicare. But you may have to pay for Part A, and your immigration history can also affect when you are allowed to buy it.
Here is what to check before you turn 65.
Why is Part A free for most people?
Medicare Part A is premium-free if you have enough qualifying work credits.
You generally need 40 credits, which is roughly 10 years of work in jobs covered by Social Security and Medicare.
In 2026, you earn one credit for every $1,890 in earnings, up to four credits per year.
So if you moved to the U.S. later in life and have only worked here for a few years, you may not have enough credits to get Part A for free.
Your years of employment in another country generally do not count as U.S. work credits.
There is an important exception: the U.S. has Social Security totalization agreements with a number of countries. Under these agreements, credits from your U.S. and foreign work records can sometimes be combined to help you qualify for benefits.
If you worked for many years before moving to the U.S., it is worth checking whether your home country has a totalization agreement with the United States.
What if your spouse has enough credits?
This is one of the first things you should check before assuming you will have to pay.
You may qualify for premium-free Part A based on a current or former spouse’s work record, even if you never worked in the U.S. yourself.
In some circumstances, eligibility can also be based on a parent’s or child’s work record.
So if you have fewer than 40 credits, don’t look only at your own Social Security record.
Your spouse’s work history could make the difference between paying hundreds of dollars every month and paying nothing for Part A.
What if you have fewer than 40 credits?
You can still buy Medicare Part A if you meet the eligibility requirements.
The monthly premium depends on how many qualifying credits you have.
For 2026, the premiums are:
- $311 per month if you have 30 to 39 credits
- $565 per month if you have fewer than 30 credits
Those amounts are for Part A alone.
If you continue working in the U.S. and earning qualifying credits, you may eventually reach 40 credits. At that point, your Part A premium can drop to zero.
What if you just got your green card?
This is where another rule can catch people by surprise.
If you are not otherwise eligible for premium-free Part A but want to buy into Medicare, a lawful permanent resident generally must have lived in the U.S. continuously for five years before the month of applying.
So, for example, if you received your green card two years ago and do not have enough qualifying U.S. work credits, you cannot simply buy Medicare immediately based on having a green card.
You generally have to reach the five-year residence requirement first.
What about Medicare Part B?
Part A is not the whole Medicare bill.
Part B covers doctors, outpatient care and other medical services, and it has a monthly premium even if you qualify for premium-free Part A.
The standard Part B premium is $202.90 per month in 2026, with a $283 annual deductible.
Your actual Part B premium can be higher depending on your income, but $202.90 is the standard premium for 2026.
So even if you qualify for free Part A, you should not assume Medicare itself will cost you nothing.
When should you enroll?
Your first opportunity to enroll is your Initial Enrollment Period.
It is a seven-month window that starts three months before the month you turn 65 and ends three months after your birthday month.
This deadline matters because waiting too long can lead to higher premiums and gaps in coverage.
If you miss your Initial Enrollment Period, you may generally have to wait for the General Enrollment Period, from January 1 through March 31.
What happens if you enroll late?
There can be financial consequences.
Part A
If you have to buy Part A and sign up late, your premium can increase by 10%.
You generally have to pay the higher premium for twice the number of years you delayed enrollment.
Part B
The Part B penalty is different.
Your premium can increase by 10% for each full 12-month period you could have had Part B but did not sign up.
The higher premium generally continues for as long as you have Part B.
There are exceptions to some late-enrollment rules, so don’t assume that missing your Initial Enrollment Period automatically means you will owe a penalty. Your individual circumstances matter.
Is October 15 to December 7 the Medicare deadline?
No.
This is a common source of confusion.
The October 15 to December 7 Medicare Open Enrollment period is for people who are already enrolled in Medicare and want to make certain changes to their Medicare Advantage or prescription drug coverage for the following year.
It is not the normal enrollment window for someone turning 65 and signing up for Medicare for the first time.
If you are approaching 65, pay attention to your Initial Enrollment Period instead.
The numbers for 2026
| 2026 figure or rule | |
|---|---|
| Credits for premium-free Part A | 40 credits, about 10 years |
| One credit in 2026 | $1,890 in earnings, maximum 4 per year |
| Part A premium, 30 to 39 credits | $311 per month |
| Part A premium, fewer than 30 credits | $565 per month |
| Green card buy-in rule | 5 continuous years of U.S. residence |
| Standard Part B premium | $202.90 per month |
| Part B deductible | $283 per year |
| Part A late penalty | 10%, generally for twice the number of years delayed |
| Part B late penalty | 10% per full 12 months, generally for as long as you have Part B |
| Initial Enrollment Period | 7 months around your 65th birthday |
| General Enrollment Period | January 1 to March 31 |
| Medicare Open Enrollment | October 15 to December 7, for certain plan changes |
What should you check before turning 65?
If you moved to the U.S. later in life, don’t wait until your 65th birthday to figure this out.
Check your own Social Security work credits.
Check your spouse’s work record too. You may qualify for premium-free Part A through your spouse even if you do not have enough credits yourself.
If you worked in another country, check whether the U.S. has a totalization agreement with that country. Foreign credits may help in some circumstances.
And most importantly, mark your Initial Enrollment Period on your calendar.
For immigrants approaching 65, the question is not simply “Do I have a green card?”
The questions are: Do I have enough qualifying work credits, can I qualify through a family member’s record, and if I need to buy Medicare, have I met the five-year residence requirement?
Those answers determine whether Part A is free, whether you can buy it, and when you can enroll.
