Part A helps cover inpatient stays in hospitals and skilled nursing centers, some home care and some end-of-life hospice care. But it can be quite expensive if you have to make the premium payments yourself.
For most people, signing up for Medicare Part A at 65, even if they’re employed, is appealing because they don’t have to pay a monthly premium. You have earned the right to it by working 40 quarters or 10 years in total and paying Medicare taxes into the Medicare Trust Fund.
However, each person’s circumstances vary: For instance, if you’ve been putting away money tax free in a Health Savings Account (HSA) because you have a high-deductible health insurance plan from your employer and want to continue contributing, you should wait to sign up for Part A. Doing both simultaneously could set you up for an IRS penalty.
If you have other insurance through your job or your spouse’s, Part A may help after that private plan pays, potentially picking up costs the employer policy doesn’t. That can reduce what you pay out of pocket.
If you haven’t worked for 40 quarters, you can qualify for premium-free Part A through the work record of:
-
Your spouse if you’ve been married for at least one year, or
-
Your former spouse if you were married for at least 10 years, or
-
Your deceased spouse if you were married for at least nine months before the death
Your spouse or former spouse must be eligible for Social Security benefits, whether through retirement or disability, even if not yet receiving them. The same standard applies to a deceased husband or wife: If your spouse died young, your partner must have worked enough quarters to have been eligible to file for Social Security Disability Insurance (SSDI) payments, even if that never happened.
You must be single to qualify for benefits through a former or deceased spouse.
Even if you can’t get premium-free Part A, any citizen eligible for Medicare can buy Part A, but you must also get Part B or face a late enrollment penalty. If you — or your spouse or former spouse if you’re qualifying that way — have 30 to 39 quarters of work, the Part A premium is $311 a month; for 29 or fewer quarters, it’s $565.
If you continue working until you reach 40 credits, you will be able to get free Part A premiums.
Green card holders without enough work credits for premium-free Part A can purchase coverage for the same price. But they also must have five years of continuous residence in the U.S. immediately before applying for Medicare.
