Medicare Part A - How Does it Work?

You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working for a certain amount of time. This is sometimes called premium-free Part A. If you aren’t eligible for premium-free Part A, you may be able to buy it. 

Your Medicare Costs

If you buy Part A, you’ll pay a premium of either $278 or up to $506 each month in 2023 depending on how long you or your spouse worked and paid Medicare taxes. If you need help paying your Part A premium, go to pages 91–92. 

If you have questions about paying for Part A, visit Medicare.gov or call 1-800-MEDICARE. 

In most cases, if you choose to buy Part A, you must also have Part B and pay monthly premiums for both. If you choose NOT to buy Part A, you can still buy Part B if you’re eligible.

Visit Medicare.gov later this fall for 2024 amounts

What’s the Part A late enrollment penalty? If you aren’t eligible for premium-free Part A, and you don’t buy it when you’re first eligible, your monthly premium may go up 10%. You’ll have to pay the higher premium for twice the number of years you could have had Part A but didn’t sign up. For example, if you were eligible for Part A for 2 years but didn’t sign up, you’ll have to pay a 10% higher premium for 4 years

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