Is Medicare Part A free?
Most people qualify for premium-free Medicare Part A. However, there are exceptions that can require a person to pay an additional premium.
There may also be options to pay zero-premium amounts for other parts of Medicare, including Part B, Part C, Part D, and Medigap.
This article looks at how a person may get Part A at no cost, or why they might have to pay a premium. It also discusses options to help pay premiums for other parts of Medicare coverage.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare Part A free of cost
This article originally appeared on Medical News Today
Original Medicare includes Part A, hospital insurance, and Part B, medical insurance. Most people do not pay the premium for Medicare Part A. However, there are exceptions when a person may have to pay the Part A premium.
Qualifying conditions for free Medicare Part A
For a person to qualify for premium-free Medicare Part A, they must meet certain conditions. They must:
be 65 years or older
be eligible for monthly Social Security or Railroad Retirement Board (RRB) cash benefits
have end-stage renal disease
If a person receives Social Security or RRB benefits at least 4 months prior to their 65th birthday, then they will automatically receive Medicare Part A. If they do not receive either of these benefits they may still be eligible for Medicare Part A but must file an application.
A person must earn enough quarters of coverage (QCs) in their working life to be eligible for Social Security Benefits. QCs are ‘earned’ through payroll taxes. Employers deduct payroll taxes from each paycheck under the Federal Insurance Contributions Act (FICA).
If a person or their spouse has worked for 10 years or more they will generally have paid the full FICA tax by payroll deduction, and meet the conditions to get premium-free Medicare Part A.
Premium-free Medicare Part A under 65
If a person is under 65, they may still qualify for premium-free Part A if they meet the following conditions:
they are eligible for Social Security benefits due to disability
has end stage renal disease (ESRD)
has amyotrophic lateral sclerosis (ALS)
Paying a premium for Part A
If a person is not eligible for premium-free Part A, they can buy it. In 2024, the premiums range from $278 to $505. The cost depends on how much taxes a person paid during a certain amount of calendar quarters:
Can I get no-cost premiums for other parts of Medicare?
Medicare includes Part A, Part B, Part C, and Part D. There are several programs that may help a person to get reduced or premium-free Medicare parts B, C, and D. However, as of 2020, enrolleees can no longer sign up for Medigap plans to pay for Medicare Part B premiums.
For example, a person with certain income and assets conditions may get some parts of Medicare premium-free through the Medicare savings programs (MSPs), which are run by state governments.
Other programs include Extra Help and Medigap.
Medicare Part B
Medicare Part B covers doctor services, outpatient hospital services, durable medical equipment, some home health services, and some other medical services not covered by Medicare Part A.
Medicare savings programs
MSPs may pay premiums, copays, coinsurance, and deductibles for individuals with certain income and assets. There are four types of MSPs:
Qualified Medicare Beneficiary (QMB) program
Specified Low-Income Medicare Beneficiary (SLMB) program
Qualified Individual (QI) program
Qualified Disabled and Working Individual (QDWI) program
The monthly premium a person pays is based on their income level. The Part B premium may be deducted from a monthly benefit check if they receive any of the following:
Social Security benefits
railroad retirement board benefits
office of personnel management payments
Supplement Insurance
A Medicare Access and CHIP Reauthorization Act of 2015 made it unlawful for supplement plans to pay Part B deductibles. So, new Medicare enrollees no longer have access to some supplement insurance plans, also known as Medigap, that may pay Part B deductibles.
Medicare Part C
Medicare Part C, also known as Medicare Advantage, are private insurance plans offered by companies approved by Medicare. They offer the same coverage as original Medicare, and may have additional benefits.
A person must be enrolled in Medicare parts A and B to enroll in a Medicare Advantage plan.
Zero-premium Medicare Advantage plans have no monthly premium, although a person may still need to pay for the Part B premium. However, zero-premium plans may have higher deductibles, copays, or additional out-of-pocket costs compared to an Advantage plan with a monthly premium.
Medicare Part D
Medicare Part D is prescription drug coverage. A person can enroll in the plan, or it may be included as part of an Advantage plan.
The premiums for Part D vary, generally according to a person’s income. If a person qualifies for certain MSPs, they may get help with their Medicare prescription drug costs.
The Extra Help program may also help a person with premiums and other costs such as deductibles and coinsurance.
Can I get free Medicare supplement insurance?
Medigap is health insurance sold by private insurance companies. It is designed to supplement original Medicare coverage by paying costs that original Medicare does not cover.
A Medigap policy may pay a person’s healthcare costs, such as coinsurance, deductibles, and copays. However, Medigap is not free, and a person may have to pay a monthly premium. A person can get more details online.
Summary
Most people receive Medicare Part A at no cost, but some people may need to pay a monthly premium. A person who is not eligible for premium-free Part A can buy coverage.
Medicare offers several programs to help a person with costs.
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View the original article on Medical News Today
