Eligibility for premium-free Part A if you are over 65 and Medicare-eligible - Medicare Interactive (2024)

FAQs

Eligibility for premium-free Part A if you are over 65 and Medicare-eligible - Medicare Interactive? ›

Premium-Free Medicare Part A Based on Age

Part A (Hospital Insurance) costs. $0 for most people (because they or a spouse paid Medicare taxes long enough while working - generally at least 10 years). If you get Medicare earlier than age 65, you won't pay a Part A premium. This is sometimes called “premium-free Part A.”

If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65. (If your birthday is on the first of the month, coverage starts the month before you turn 65.)

Why might a person not be eligible for Medicare Part A? A person must be age 65 years or older to qualify for Medicare Part A. Unless they meet other requirements, such as a qualifying disability, they cannot get Medicare Part A benefits before this age.

Monthly premium

Nothing if you or your spouse worked for 40 calendar quarters (10 years) or more in the U.S. $278 if you or your spouse worked between 30 and 39 quarters (7.5 and 10 years) in the U.S. $505 if you or your spouse worked fewer than 30 quarters (7.5 years) in the U.S.

Enrollees who have Medicaid, employer-sponsored health coverage, or retiree health benefits from an employer generally don't have to pay the full Medicare Part B deductible, as the other coverage picks up some or all of the cost (this varies depending on the plan).

Californians with an annual income of less than $20,121 for an individual or $27,214 ​​​for a couple are eligible for a Medicare Savings Program. These programs provide help from the State of California to pay for your Medicare premiums, and sometimes your deductibles and copayments.

Medicare Eligibility for People Who Never Worked

The most common way for people who haven't worked 10 years to qualify for Medicare Part A without a premium is by claiming the work history of a spouse (or former spouse).

Part A late enrollment penalty

If you have to buy Part A, and you don't buy it when you're first eligible for Medicare, your monthly premium may go up 10%. You'll have to pay the penalty for twice the number of years you didn't sign up.

Medicare Part D eligibility is primarily age-based, with individuals turning 65 and those with qualifying disabilities, including those on Social Security Disability Insurance (SSDI) or with End-Stage Renal Disease (ESRD), being eligible for this prescription drug coverage.

Does everyone pay $170 for Medicare? ›

If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($174.70 in 2024). Social Security will tell you the exact amount you'll pay for Part B in 2024.

Most people qualify for no-cost Medicare Part A because they paid Medicare taxes for 10 years or are eligible for a waiver. If you are 65 or older, you have to meet the work requirement to get free Part A. But if you qualify for Medicare because of a disability, you are automatically eligible for free Part A.

You pay nothing for covered services the first 20 days that you're in a skilled nursing facility (SNF). You pay a daily coinsurance for days 21-100, and you pay all costs beyond 100 days. Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to get current amounts.

Most people don't pay a Part A premium because they paid Medicare taxes while working. If you don't get premium-free Part A, you pay up to $505 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty.

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, based on your “modified adjusted gross income” (MAGI).