Isn’t Medicare Part A Free?

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Toni,

I need your help! I’ve made a mistake enrolling in Medicare. This February, my husband, Sonny, was laid off and lost his employer’s health insurance, which I was also on. He’s a veteran and receives his health care from the VA. Therefore, he didn’t have to enroll in Medicare, so his healthcare isn’t costing us anything.

I enrolled in Medicare since I’m going to turn 65 in April. Unfortunately, I’m not sure if I enrolled properly. My Medicare is costing me an extra $505 for Medicare Part A and $174.70 for Medicare Part B. Isn’t Medicare Part A free?

I haven’t worked very much since Sonny and I got married 40 years ago. Social Security told me that’s my issue. Please explain what I should do to correct my Medicare mistake.

Thank you, Toni,
Terry from Laredo, TX

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Hi Terry,

No, Medicare Part A is NOT free! Many Americans aren’t aware that they must work a certain amount of time and pay employment taxes to receive premium-free Medicare Part A. This is most likely the cause of your problem. Don’t feel bad. The Toni Says® Medicare team helps resolve this issue quite often. Let’s break it down, step by step.

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Who’s Eligible for Medicare Part A?

To qualify for Medicare Part A at no cost, you must have worked (and paid) Social Security and Medicare taxes from your payroll check for 10 years or 40 quarters. Here’s an example for you:

If you paid Medicare taxes for 30-39 quarters, then the standard Part A premium is $278 each month.
If you paid Medicare taxes for less than 30 quarters, the premium for Medicare Part A is $505 each month ($1 less than in 2023).

However, those who do NOT qualify for premium-free Medicare Part A but have been married for at least 10 years to an individual who meets the 10 years (or 40 quarters) requirement should apply for Medicare under their working spouse’s Social Security number. What this means for you, Terry, is that you should’ve applied for Medicare under Sonny’s account.

Where Should Terry Go From Here?

My advice to Terry and others in her position is to contact their local Social Security office. For those who don’t know, that’s the government office that enrolls Americans in Medicare. Ask the Social Security representative to appeal your Medicare Part A premium of $505. Explain that you’ve been a stay-at-home spouse, but your husband has worked enough quarters to qualify for premium-free Medicare Part A.

Social Security will look over your husband’s Social Security accounts and verify with the IRS that he has enough quarters to qualify for premium-free Medicare Part A. Be prepared to provide a certified marriage license showing you are married. You will have to provide the original certified marriage license (not a copy) to Social Security.

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You’ll have to pay for your Medicare Part A premium if you:
- Did not work enough quarters to qualify.
- Have never married or lived with someone as a domestic partner
- Are married to or living with a domestic partner who didn’t work enough quarters to qualify.

Can I still qualify if I’m divorced or widowed?

Maybe, unlike Terry, you’re divorced and wondering how you should proceed. Or maybe you’re a widow or widower who isn’t sure what your next steps should be. Does your marital status affect your ability to get Medicare Part A? Good news—the answer is no! You can still qualify for Original Medicare (Parts A and B) if you:

Are 65 or older, and you meet the citizenship and residency requirements.
Get disability benefits from Social Security or the Railroad Retirement Board for at least 25 months.
Get disability benefits because you have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig’s disease).
Have ESRD and meet certain requirements.

In other words, marital status has nothing to do with your Medicare eligibility! However, it could impact the cost of your Medicare Part A premium (according to United Healthcare). Most individuals do qualify for premium-free Medicare Part A due to their work history. If you’ve been divorced and have never worked (or didn’t work long enough to qualify for premium-free Medicare Part A), don’t despair. You may still be able to qualify for premium-free Medicare Part A under certain circumstances. These are:

You were married at least 10 years before the date your divorce was finalized, or
You were married a least 1 year before your spouse passed away.

Additionally, per United Healthcare, you may receive premium-free Part A if your former or late spouse paid Medicare taxes for 10 years (40 quarters). Circumstances vary from person to person, so make sure you know what your situation is and understand the cost of your premium before you enroll!

Readers—don’t forget how important working and paying taxes for 40 quarters is to enroll in Medicare! What you don’t know about enrolling in Medicare WILL hurt you.