Do you have to pay for Medicare Part A?
Most people don't. Your work record, or your spouse's, decides.
About 99% of people with Medicare pay no premium for Part A, because they or a spouse paid Medicare taxes for at least 40 quarters of work. If you don't have enough quarters, you can still get Part A by paying for it.
Part A premiums in 2026
- 40 or more quarters: $0.
- 30 to 39 quarters: $311 a month.
- Fewer than 30 quarters: $565 a month.
Using a spouse's record
You can qualify for premium-free Part A on a current spouse's work record, and in some cases on a former or deceased spouse's record, such as a marriage that lasted at least 10 years. Social Security checks this when you apply.
Rules for buying Part A
To buy Part A you must also have Part B. If you sign up late, a penalty can apply: your Part A premium may rise 10%, paid for twice the number of years you could have had Part A but didn't.
Lawful permanent residents who need to buy Part A or Part B must have lived in the US continuously for at least 5 years.
Help paying
The Qualified Medicare Beneficiary (QMB) program can pay the Part A premium for people with limited income and resources, and many states will enroll you in Part A as part of that. Ask your State Health Insurance Assistance Program.
Common questions
Yes. If you're close to 40 quarters, working longer can make Part A premium-free. Social Security can tell you how many quarters you have.
Generally yes. People entitled to Medicare through Social Security or Railroad Retirement disability benefits get premium-free Part A.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- 2026 Medicare Parts A & B Premiums and Deductibles, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- Medicare costs, Medicare.gov. Checked September 29, 2026.
- Avoid late enrollment penalties, Medicare.gov. Checked September 29, 2026.
- CY 2027 Physician Fee Schedule proposed rule (91 FR, 16 Jul 2026), Federal Register. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.