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What happens if you don't qualify for Medicare?


What happens if you don't qualify for Medicare?

My brother is 57-years old and has 29 Social Security credits (so he's 11 short of the 40 credits needed to qualify). He currently receives Obama Care subsidies for his health insurance based on his income. My understanding is that he won't qualify for Medicare when he turns 65 or he'll have to pay for coverage. I think his Obama Care subsidies will end at that point as well.


I realize a simple solution would be for him to earn the 11 credits but he was a caregiver for our mother for decades and has been out of the work force for a long time. His marketable skills are limited. 


Can anyone clarify for me what will happen with Medicare when he turns 65? We're in California.



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Community Concierge

@e994792f Since he has accrued fewer than 30 work credits, he will pay the maximum premium for Medicare Part A, which is $471 in 2021. 


If you have 30 to 39 credits, you pay less — $259 a month in 2021. If he continues working until he gains 40 credits, he will no longer pay these premiums. Learn more here:

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Honored Social Butterfly


Based on what indications you have given on his income, it sounds like you are right - His Medicare Part A won't be completely free due to his lack of working under the system for long enough to get it "free".  He will have to do a buy-in - but that might not be as big a deal as you think.  The price of a Medicare Part A buy-in will be proportionate to the amount of time that he did work and pay Medicare taxes - if he can get those credits up to at least 30, there is a substantial difference in the price (see the link below).  These cost are what are now in effect in 2021 - by the time he gets to 65 years old, if nothing has changed with the program, the cost for all the Parts of Medicare will probably be higher. - 2021 Cost at a Glance

from the link ~

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $471 each month in 2021. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $471. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $259.


Everybody on Medicare, unless they are deemed to be very low-income eligible, also pays a Part B premium each month.  For most people on Medicare in 2021, this monthly cost is a $148.50 per month with higher income seniors paying more.

You can read about Part B premiums and also Part D premiums at the above link also.


Nobody knows what his cost will be by the time he reaches 65 but this will give you an idea of the 2021 cost.  Anything can happen with medical cost - there are no assurances.




It's Always Something . . . . Roseanna Roseannadanna

Paying the Part A premium is significantly less than unsubsidized Obamacare premiums and the coverage is significantly better with Medicare.

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