Is Medicare Free?

Medicare Part A is premium-free for most people, however, there may be other associated costs.
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Medicare Part A, which covers hospital care and related services, is the only part of Medicare that has free premiums (for the majority of recipients). The other parts of Medicare come with some type of monthly premium, with the exception of some Medicare Advantage plans

Centers for Medicare & Medicaid Services. Costs. Accessed Oct 2, 2023.
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Most people (about 99%) who have Medicare Part A don’t have to pay a premium, according to the Centers for Medicare & Medicaid Services (CMS)

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Is Medicare Part A free?

To qualify for premium-free Medicare Part A, you (or your qualifying current or former spouse) need to have worked and paid Medicare taxes for a specific period of time, typically at least 10 years (or 40 quarters). According to Medicare.gov, you won’t have to pay a premium for Part A coverage if:

  • You qualify for (or are already receiving) retirement or disability benefits from Social Security or the Railroad Retirement Board.

  • You qualify for Medicare before you reach 65 years old.

If you don’t qualify for premium-free Medicare Part A, you may be able to buy the hospital coverage. For those who have to purchase Medicare Part A, the premium depends on how many qualifying quarters you worked and paid Medicare taxes

Centers for Medicare & Medicaid Services. What's Medicare?. Accessed Oct 2, 2023.
:

  • If you paid Medicare taxes for 30 to 39 quarters, the Part A premium is $278 per month in 2024.

  • If you paid Medicare taxes for fewer than 30 quarters, the Part A premium is $505 per month in 2024.

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Are there any other costs associated with Medicare Part A?

Even if your Medicare Part A is premium-free, there are other associated costs with this hospital insurance that you should be aware of. The table below summarizes your share of costs when in a hospital or skilled nursing care. Depending on the specifics of your Medicare Supplement Insurance, or Medigap, plan or Medicare Advantage policy, these costs may be covered by that insurance.

Services

Costs*

Inpatient hospital care

  • $1,632 deductible for each benefit period.

  • Coinsurance of $0 per day in 2024 for days 1-60 of each benefit period.

  • Coinsurance of $408 per day in 2024 for days 61-90 of each benefit period.

  • Coinsurance of $816 per day in 2024 for days 91 and beyond of each benefit period, up to your total lifetime reserve days (60 days over your lifetime).

  • All costs after exceeding lifetime reserve days.

Skilled nursing facility care

  • Coinsurance of $0 per day for days 1-20 for each benefit period (which starts on the day you’re admitted and ends when you haven’t received inpatient hospital or skilled nursing facility care for 60 days).

  • Coinsurance of up to $204 in 2024 per day of each benefit period for days 21-100.

  • All costs for days 101 and beyond.

Hospice

  • $0 for hospice care.

  • $5 or less on copayments for prescription drugs for pain relief or symptom relief at home.

  • 5% of Medicare-approved amount for occasional inpatient respite care, in some cases.

Home health services

  • $0 for covered home health services.

  • 20% of the Medicare-approved amount for certain medical equipment, such as wheelchairs and walkers.

*Your share of Part A costs if you don't have supplemental insurance that covers these deductibles and coinsurance charges.

Are the other parts of Medicare free?

In general, you’ll pay a monthly premium for each part of Medicare, depending on which parts you’re enrolled in:

Part of Medicare

Monthly cost

Part A (hospital insurance)

Typically $0.

Part B (medical insurance)

Typically $174.70 in 2024.

Part C (Medicare Advantage)

$18.50, on average, in 2024.

Part D (prescription drugs)

$55.50, on average, in 2024.

Medigap

Varies by plan.

Medicare Part C (Medicare Advantage), Medicare Part D (prescription drug coverage) and Medigap plans are sold by private health insurance companies. These companies set the premiums, and the majority of Medicare Advantage plans have a $0 premium. (However, if you purchase Medicare Advantage, you're still responsible for the Medicare Part B premium, which is $174.70 per month in 2024.)

Is there help for Medicare costs?

There are a number of federal and state programs to help people on Medicare with limited income and resources pay for their health care and medications

Centers for Medicare & Medicaid Services. 4 Programs That Can Help You Pay Your Medical Expenses. Accessed Oct 2, 2023.
. These include:

  • Qualified Medicare Beneficiary Program (QMB): This Medicare Savings Program helps pay premiums for Medicare Part A and Part B. When on the QMB program, Medicare providers can’t bill you for deductibles, coinsurance or copayments for covered items and services, except outpatient prescription drugs. 

  • Specified Low-Income Medicare Beneficiary Program (SLMB): This Medicare Savings Program helps pay Medicare Part B premiums only.

  • Qualifying Individual Program (QI): This Medicare Savings Program helps pay Medicare Part B programs only and requires you to reapply every year. 

  • Qualified Disabled and Working Individuals Program (QDWI): This Medicare Savings Program is open to people who are living with a disability and working. It helps pay Medicare Part A premiums only.

  • Supplemental Security Income (SSI): This Social Security cash benefit is available to people with limited income who are blind, living with a disability or age 65 and older.

  • Medicaid: A joint federal and state program that helps pay medical costs.

  • Extra Help: This Medicare program helps pay Medicare prescription drug costs. You automatically qualify for Extra Help if you qualify for any of the Medicare Savings Programs, SSI or Medicaid.

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).

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