No, Medicare isn't completely free at 65; while Part A (hospital) is often premium-free if you've paid Medicare taxes for 10+ years, you usually pay premiums for Part B (medical) and have deductibles, copays, and coinsurance, plus optional Part D (drugs) and Medigap plans have extra costs.
No, you don't have to pay for Medicare Part A if you or your spouse paid Medicare taxes for at least 10 years, making it premium-free for most people, but you generally do pay a premium for Part B (medical insurance) unless you have other creditable coverage. While not mandatory, delaying enrollment in Part B can lead to penalties, and if you don't sign up for any Medicare when first eligible (around 65), you might face late enrollment fees, so it's often wise to enroll, even if you delay Part B if you have employer coverage.
Exemptions from Medicare tax apply mainly to specific employment situations, like certain religious objectors (Amish/Mennonite) and some foreign workers (students, temporary scholars). U.S. citizens working for foreign governments or specific state/local employees hired before 1986 (with public pension plans) can also be exempt, as can students working for their universities under certain conditions. Generally, if you have earned income and aren't in one of these categories, you'll pay the Medicare tax.
Part A is free if you worked and paid Medicare taxes for at least 10 years. You may also be eligible because of your current or former spouse's work.
Premium-Free Medicare Part A Based on Age
To be eligible for premium-free Part A on the basis of age: A person must be age 65 or older; and. Be eligible for monthly Social Security or Railroad Retirement Board (RRB) cash benefits.
You can avoid paying Medicare Part B premiums by delaying enrollment if you have creditable employer coverage (your own or spouse's job with 20+ employees) until that coverage ends (within 8 months to avoid penalties), or by qualifying for a Medicare Savings Program (MSP) to have state/federal funds pay for it due to low income. Other ways to save include using HSA funds, appealing high Income-Related Monthly Adjustment Amounts (IRMAA) for life changes, or enrolling on time during your Initial Enrollment Period.
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If you reach age 65 and already have comprehensive health insurance, you don't have to enroll in Medicare right away, but in some cases, enrollment at age 65 is essential to avoid gaps in coverage.
Yes, you can get Medicare even if you've never worked, but your eligibility and costs (especially for Part A) depend on your age, citizenship, residency, and your spouse's work history, with many without work credits paying premiums for Part A and B, though some qualifying disabilities or ESRD can grant premium-free Part A.
Your CalPERS health coverage will automatically be canceled the first day of the month after you turn 65.
Medicare Part B premiums are automatically deducted from Social Security checks, with the standard monthly amount for 2026 being $202.90, but this amount increases for higher-income earners. Most people get Part A for free, but if you pay premiums, they're also deducted. Part D (prescription drug) premiums can also be optionally deducted, while Part C (Medicare Advantage) premiums vary.
If you have a Medicare Part D plan, you may pay premiums, deductibles, copayments, and/or coinsurance for your drug coverage. Learn more about the out-of-pocket costs you might pay for a Medicare Part D prescription drug plan in 2026.
Yes, you can have both Social Security and Medicare at the same time, and they often work together, with your Social Security record qualifying you for Medicare, especially if you're 65+ or have received Social Security disability for 24 months. Most people sign up for both through the Social Security Administration (SSA).
Starting in 2025, there is an annual limit on what you pay out-of-pocket for prescription medications through Medicare and Medicare Advantage prescription drug plans. All prescription medications, including specialty medications, covered by Part D plans are included under this cap.
How much you pay for Medicare overall will depend on how much you earned when you signed up. There are many types of Medicare plans, and some types of plans have higher premiums. This is usually a monthly cost. to reduce other costs. If you signed up for Medicare late, you may have penalties added to your premium.
As of November 2023, the income limits for free Part B coverage are as follows: Individuals with an income at or below 135% of the FPL: Individuals whose income falls at or below this threshold may qualify for free Part B coverage. As of now, the income limit for an individual is $1,640 per month or $19,683 per year.
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.
If you can't afford Medicare Part B, you should immediately contact your State Medical Assistance (Medicaid) office to apply for a Medicare Savings Program (MSP), which can pay your Part B premiums and other costs if you have low income/resources, or explore options like Supplemental Security Income (SSI), or even look into Medicaid itself for comprehensive help, as delaying Part B can lead to lifetime penalties.
In 2025, the standard Medicare Part B premium is $185 per month, with an annual deductible of $257, though higher-income earners pay more (Income-Related Monthly Adjustment Amount or IRMAA), and some with Social Security benefits pay less due to the "hold harmless" rule.
There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.