You do not need to have filed tax returns to qualify for Medicare, but you must have worked and paid Medicare taxes for at least 10 years (40 quarters) to receive premium-free Part A. If you have not paid these taxes, you can still enroll in Medicare at 65 but will likely have to pay a monthly premium for Part A.
The answer is yes, you can still enroll in Medicare if you have never worked or worked for fewer than 10 years. But your Medicare coverage may cost more because you have not paid enough taxes into the program. No one enjoys paying taxes, but programs like Medicare wouldn't exist without them.
The three core requirements for Medicare eligibility generally center on age (65+ or younger with specific conditions like disability/ESRD/ALS), U.S. citizenship/legal residency (5+ years), and sufficient work history (10 years for premium-free Part A), though some (like ESRD/ALS) bypass age, and individuals must also qualify for Social Security or Railroad Retirement benefits to get premium-free coverage, notes Medicare School.
Each fall, when we ask the IRS for information to determine next year's premiums, we ask for tax information to verify your reports of changes affecting your income-related monthly adjustment amounts, if any. We also ask the IRS for your two-year-old MAGI if we've temporarily used three-year-old MAGI.
Everything from a felony conviction to a simple punctuation error can be the reason for the rejection of your application. We know the enrollment process is time-consuming and frustrating already, but with a denial, it can be especially difficult.
Here are some of the biggest Medicare mistakes to avoid:
The current Medicare tax rate for employed individuals is 1.45%. For self-employed individuals, the rate is 2.9%. There is no wage base for the Medicare tax. No matter how much you earn, you are required to pay Medicare tax.
We use the most recent federal tax return the IRS provides to us. If you must pay higher premiums, we use a sliding scale to calculate the adjustments. This is based on your "modified adjusted gross income" (MAGI).
The first step when applying for Medicare (Parts A & B) is to contact the Social Security Administration (SSA), either online at ssa.gov/medicare, by phone, or in person, especially if you're not already getting Social Security benefits, to begin the enrollment process during your Initial Enrollment Period (IEP) around age 65. If you're already receiving Social Security, you'll likely be automatically enrolled, but you still need to decide about Part B.
If you waited 2 full years (24 months) to sign up for Part B and didn't qualify for a Special Enrollment Period, you'll have to pay a 20% late enrollment penalty (10% for each full 12-month period that you could have signed up), plus the standard Part B monthly premium ($202.90 in 2026).
The levy is continuous until the overdue taxes are paid in full, or other arrangements are made to satisfy the debt. So if you owe back taxes, the IRS will arrange to take 15 percent of your Medicare reimbursements until your levy has been satisfied.
Strictly speaking, Medicare is not mandatory. But very few people will have no Medicare coverage at all – ever. You may have good reasons to want to delay signing up, though.
The new senior tax deduction of up to $6,000 for single filers and $12,000 for joint filers, was created to help cover taxes on Social Security benefits. Taking the new senior deduction helps to reduce your taxable income, which can mean less tax or potentially an even bigger tax refund when you file your return.
To qualify for the federal Credit for the Elderly or the Disabled, you must be age 65 or older OR retired on permanent and total disability and meet specific income limits (Adjusted Gross Income and nontaxable income) for your filing status, plus be a U.S. citizen or resident alien. For those under 65, you must also have been permanently disabled before retiring and receive taxable disability income, notes the IRS and the National Council on Aging.
Yes, Medicare premiums (Parts A, B, C, and D) can be tax-deductible as medical expenses if you itemize deductions on Schedule A and your total qualified medical costs exceed 7.5% of your Adjusted Gross Income (AGI), but self-employed individuals have a special rule allowing them to deduct premiums above the line, directly reducing AGI.
Establish an Irrevocable Trust
Cash, property, and investments can be transferred into an irrevocable trust. By doing so, these assets would be removed from Medicaid's calculation. However, this trust would need to be established at least five years before applying for Medicaid to avoid lookback scrutiny.
Medicaid agencies can check your account balances for bank accounts at any financial institution you've used in the past five years. They will check when you submit an application and on an annual basis, but checks can occur at any time.
Generally, you're first eligible to sign up for Part A and Part B starting 3 months before you turn 65 and ending 3 months after the month you turn 65. (You may be eligible for Medicare earlier, if you get disability benefits from Social Security or the Railroad Retirement Board.)