Find out who qualifies for Medicare and how to buy Part A if it's not premium-free for you.
Medicare, the federal health insurance program, is coverage available to people age 65 and older and younger people who live with qualifying disabilities. To be eligible for enrollment, you must be age 65 and a U.S. citizen or lawful permanent resident, unless you’re receiving Social Security retirement benefits, U.S. Railroad Retirement Board (RRB) benefits, or Social Security Disability Insurance (SSDI).
Note: If you do become eligible for Medicare benefits and do not enroll, you may have to pay a late enrollment penalty once you sign up unless you have other creditable coverage. There are also special enrollment periods to sign up if you meet specific criteria, and open enrollment periods each year to make changes.
You must enroll in Original Medicare (Parts A and B) to opt for a Medicare Advantage Plan (Part C), Part D prescription drug coverage, or a Medicare supplement (Medigap).
The age requirement for Medicare insurance is three months before you turn 65 unless you’re entitled to disability benefits or have permanent kidney failure, also called end stage renal disease (ESRD). In those cases, the age requirement of 65 is not enforced, but restrictions and timeframes apply.
Most people who are eligible don’t have to pay a premium for Part A because they have worked at least 10 years (40 quarters) and made Medicare tax payments or have worked for the Railroad Retirement Board or in a civil service job.
If you’re 65 or older, you can receive Medicare Part A benefits premium-free under any of these circumstances:
If you’re younger than 65, you can receive Medicare Part A premium-free under any of these circumstances:
If you don’t have eligibility for premium-free Part A, you can buy Medicare Part A by paying premiums if you are 65 or older and a U.S. citizen/permanent resident.
You’ll pay a premium of either $259 or up to $471 each month in 2021 depending on how long you or your spouse worked and paid Medicare taxes. If you or your spouse paid taxes for 30 to 39 quarters, your Part A monthly premium will be $259. If you or your spouse paid taxes for less than 30 quarters, your premium will be $471 per month.
If you’re paying premiums for Medicare Part A, and if you continue to work and pay Medicare taxes, those quarters will count toward your total number of quarters worked. Your premiums for Part A will be free once you work 40 total quarters.
In most cases, if you choose to buy Part A coverage, you must also have Medicare Part B and pay monthly premiums for both. If you choose not to buy Part A, you can still buy Part B. Whether you pay Part A premiums or not, and regardless of whether or not you opt for Original Medicare Parts A and B, or a Medicare Advantage or Medigap plan, you’ll always pay a Part B premium.
You can get help paying for insurance premiums if you qualify for a Medicare Savings Program; eligibility is based on if your income and resources are below a certain limit. To find out if you’re eligible and your expected premium go to the Medicare eligibility premium calculator tool.
LeRon Moore has guided Medicare beneficiaries and their families as a Medicare professional since 2007. First as a Medicare provider enrollment specialist and now a Medicare account executive, Moore works directly with Medicare beneficiaries to ensure they understand Medicare and Medicare Advantage Plans.
Moore holds a bachelor’s degree from Southern New Hampshire University and is A+ Certified with a Medical Records Clerk Certification and Medical Terminology Certification from Midlands Technical College.
He’s passionate about educating, informing, and resolving issues concerning Medicare and MA Plans, and considers it imperative that he does all he can to educate and inform the senior community as much as possible about Medicare.