You qualify for premium-free Medicare Part A at age 65 if you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), are eligible for Social Security/RRB, or if you're under 65 and received disability benefits for 24 months, have ESRD, or ALS. Eligibility also requires being a U.S. citizen or permanent resident.
To qualify for Original Medicare Part A, a person must be 65 years or older. Unless they meet other requirements, such as a qualifying disability, they cannot get Medicare Part A benefits before this age. Some people may be 65 years old but ineligible for premium-free Medicare Part A.
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 $565 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.
Call the Social Security Administration at (800) 772-1213 and ask if your Medicare Part A (hospital insurance) is free and when your coverage starts.
Medicare Part A is usually free if you or your spouse paid Medicare payroll taxes for approximately 10 years while working (this is called “premium-free Part A”). If you don't qualify for premium-free Part A, you may have the option to pay for hospital insurance, also called “premium Part A.”
The bottom line. You cannot make too much money to qualify for Medicare. Eligibility is based on age or disability status, not income. That said, higher earnings can trigger income-based surcharges on premiums, particularly for Part B and Part D coverage.
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Medicare and Medicaid have different rules regarding Social Security income: Medicare does not count Social Security benefits as income for premium calculations. However, Medicare Savings Programs (MSPs) and Medicaid eligibility consider Social Security as part of total income.
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.
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.
Most people don't pay the Medicare Part A premium. You do not pay for Part A if you or your spouse worked and paid Medicare taxes for at least 10 years. If you or your spouse did not, then you will have a Part A premium to pay each month. As of 2025, the Part A premium can cost up to $518 per month.
The Medicare 2-Midnight Rule is a Centers for Medicare & Medicaid Services(CMS) guideline for hospital admissions, stating that if a doctor expects a patient to need hospital care crossing at least two midnights, the stay generally qualifies for Medicare Part A inpatient payment;
Medicare Part A does not typically cover outpatient surgery. Part A is hospital insurance. It covers inpatient hospital care and services. Outpatient surgery is covered by Medicare Part B.
The Medicare "3-Day Rule" requires a beneficiary to have a qualifying 3-day inpatient hospital stay (admission day counts, discharge day doesn't) before Medicare will cover services in a Skilled Nursing Facility (SNF) for rehabilitation or skilled care, though this rule can be waived in certain Medicare Advantage plans or through specific Accountable Care Organization (ACO) initiatives. Time spent in observation or the Emergency Department doesn't count towards these 3 days, but new demonstration projects and waivers are emerging to offer more flexibility for patients needing SNF care.
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.
IRA and 401(k) withdrawals can change what you have to pay for Medicare. This happens because those withdrawals add to your adjusted gross income and modified adjusted gross income.
If you can't afford your Medicare premium, you likely qualify for financial help through Medicare Savings Programs (MSPs) or Extra Help, which cover premiums, deductibles, and drug costs for those with limited income and assets; start by visiting BenefitsCheckup.org or calling your State Health Insurance Assistance Program (SHIP) for personalized assistance. You can also get help from Medicaid or contact your State Medical Assistance office.
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.
Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024.
Medicare Part A doesn't help cover doctors' appointments, but Medicare parts B and C do. Instead, Medicare Part A helps cover doctors' services and other essential care if you receive inpatient care in a hospital, skilled nursing facility, or another healthcare center.