Medicare Part A Costs and How to Get Assistance


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This article was updated on December 3, 2020. 

Medicare Part A covers hospital and inpatient treatment. Most people won’t need to pay a premium for this coverage if they or their spouse has paid into Medicare through payroll taxes for at least 10 years. Here’s a breakdown of Medicare Part A premiums, and what to do if your coverage isn’t free.

Part A premiums

Premium-free Part A isn’t exactly free. You earn “free” Part A coverage by working and paying into the Medicare system through payroll taxes. In order to earn premium-free Part A, you should have a work history of about 10 years, or 40 quarters of work credit.

If not, the 2021 Part A premium costs are:

  • $259 per month for 30-40 quarters, or
  • $471 per month for 30 quarters or fewer.

Part A deductible

A deductible is the amount of money you pay out of pocket before your insurance plan will pay a claim. The deductible for Medicare Part A in 2021 is $1,484 per benefit period. After you’ve met this deductible, Medicare will pick up 80 percent of Medicare-approved services, while you will be responsible for the remaining 20 percent.

For example, if you have a hospital visit with a total cost of $3,500, here’s how the math would break down:

  • Total cost of hospital visit: $3,500
  • Medicare Part A deductible: $1,484
  • Remaining balance: $2,016
  • Medicare pays 80 percent of remaining balance: $1.612.80
  • You pay 20 percent of remaining balance: $403.20
  • Your total cost: $1,887.20

Qualifying for premium-free Part A

You can get premium-free Part A at 65 if:

  • You already receive retirement benefits from Social Security or the Railroad Retirement Board,
  • You are eligible for Social Security or Railroad Retirement Board benefits but do not collect them yet, or
  • You or your spouse had Medicare-covered government employment.

If you’re under 65, you can get premium-free Part A if you:

  • Received Social Security or Railroad Retirement Board disability benefits for 24 months,
  • Have end-stage renal disease (ESRD), or
  • Have ALS, or Lou Gehrig’s disease.

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Qualifying through your spouse

If your spouse has at least 40 quarters of work credit, it may qualify you both for premium-free Part A.

However, your marital status determines your qualifications. If you are:

  • Married, you need to have been married for a year
  • Divorced, you need to have been married to your qualifying spouse for at least 10 years and currently single
  • Widowed, you need to have been married to your qualifying spouse for at least nine months and currently single

Help to pay for Part A

Medigap. If you have trouble paying for your Part A premiums, you might consider a Medigap plan. This type of plan, also known as Medicare Supplement, “fills the gaps” in your Medicare coverage. For a low monthly premium, some plans will cover your Part A and Part B premiums, deductibles, and copays.

Medicaid. Medicare beneficiaries living with low or limited incomes may qualify for Medicaid in addition to their Medicare benefits.

Important notes

  • Medicare Part B is never premium-free and not dependent upon your work history of that of your spouse.
  • If you don’t automatically qualify for premium-free Part A and you delay enrolling when you are first eligible, you could later be hit with a late enrollment penalty. This could raise your Part A premium as much as 10 percent for every year you go without Part A coverage. When you first become eligible, enroll right away and don’t delay.

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Find a Medicare Plan Near You!

Speak to a licensed broker who can help you look for plans.

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