Medicare Part A does not have a premium for most enrolled individuals. Most people qualify for free Medicare Part A because they have worked, earned, and paid enough taxes to earn 40 work credits. Once you reach 40 work credits, you qualify for Social Security benefits and premium-free Part A upon meeting other qualifications, like turning 65 or becoming disabled.
You qualify for premium-free Part A:
- At 65 years of age if you get or qualify for benefits from Social Security or the Railroad Retirement Board.
- At 65 years of age if you or your spouse had a Medicare-covered government job.
- Younger than 65 years of age if you get Social Security disability benefits for 24 months.
- Younger than 65 years of age if you have End-Stage Renal Disease (ESRD) and meet specific requirements.
If you do not qualify for premium-free Medicare Part A, you can pay for coverage. The monthly amount will depend on the number of work credits you or your spouse earned. As of 2023, the premium ranges between $278 and $506.
You will pay up to $506 monthly if you have less than 30 work credits. If you have between 30 and 39 work credits, the premium is $278 each month.
Medicare Part B premiums vary based on your past income but range between $164.90 and $560.50 as of 2023. If you earned less than $97,000 in 2023, for example, you would pay only $164.90 monthly for Part B coverage.
If you do not sign up for Part B when you first qualify and do not have health care coverage, you will need to pay a penalty fee when you do enroll. The late enrollment penalty fee increases the longer you go without coverage. Your premium increases 10 percent for each 12-month period you did not have Part B when you could have. Likewise, if you lost Part B, you may be subject to monthly penalty surcharges upon re-enrollment.
Medicare Part D, which is prescription drug coverage, premiums vary by plan. Most individuals only pay their Part D premiums for coverage. However, some higher earners will need to pay an additional monthly fee. You would need to pay the fee if you earned more than $97,000 as an individual filer or $194,000 as a married couple.
Insurance providers determine the premiums for Medicare Part C – or Medicare Advantage Plans.
Keep in mind that you need to pay deductibles, coinsurances, and copayments for medical services. These costs vary by plan, frequency, and other factors.