Q&A: Medicare has a prerequisite

Dear Liz: In a recent column, you mentioned that Medicare Part A is free, but that requires 40 quarters (or 10 years) of U.S. employment to qualify. There are, unfortunately, many of us with offshore employment who have found this out too late. Even if one has worked in a country with a tax treaty with the U.S. that allows you to transfer pension credits to Social Security, that will not allow you to qualify for Medicare. I think it would have been very helpful if I had known this about 10 years ago!

Answer: Medicare is typically premium-free, because the vast majority of people who get Medicare Part A either worked long enough to accrue the necessary quarters or have a spouse or ex-spouse who did. (Similar to Social Security, the marriage must have lasted at least 10 years for divorced spouses to have access to Medicare based on an ex-spouse’s record.)

But of course there are exceptions, and you’re one of them. People who don’t accrue the necessary quarters typically can pay premiums to get Part A coverage if they are age 65 or older and a citizen or permanent resident of the United States. The standard monthly premium for Part A is $437 for people who paid Medicare taxes for less than 30 quarters and $240 for those with 30 to 39 quarters.