Do I have to pay a premium for Part A?

Usually not. If you or your spouse paid Medicare taxes for 10 years or more while working, Part A comes with no premium. Without that work history, it runs about $311 to $565 a month in 2026, based on how long you worked.

More detail

Here's an example. Maria spent most of her working years raising her kids at home, but her husband paid Medicare taxes for decades. She can still get premium-free Part A based on his work record.

If you don't qualify and have to buy Part A, watch the timing. If you don't buy it when you're first eligible, your premium may go up 10%, and you'd pay that higher amount for twice the number of years you waited. Wait 2 years, for example, and you pay 10% more for 4 years. In most cases, if you buy Part A, you must also have Part B and pay both premiums.

If money is tight, a Medicare Savings Program called QMB can pay the Part A premium for people who qualify. You apply through your state's Medicaid office.

What to have ready: your work history and your spouse's, so we can see whose record you qualify under.

If you're not sure where you stand, I'm happy to help you sort it out.