What is Medicare Part A and How Much Does it Cost?

Medicare Part A is frequently referred to as the “hospital insurance” portion of Original Medicare.

Medicare Part A and Medicare Part B are the two parts of Original Medicare. Original Medicare is managed by the Federal Government and is considered a fee-for-service healthcare plan, where you pay a percentage of the costs for healthcare services you utilize.

Medicare Part A is frequently referred to as the “hospital insurance” portion of Original Medicare. It helps cover inpatient care costs (such as room cost, meals, and drugs) when you are in a hospital or skilled nursing facility that accepts Medicare. Part A can also help cover hospice care or home health care, but certain requirements must be met first.

Medicare Part B is frequently referred to as the “medical insurance” portion of Original Medicare. It helps cover doctors’ services, hospital outpatient care, and home health care.

Am I eligible for Medicare Part A?

In general, you are eligible for Medicare Part A if you are 65 and a U.S. citizen or permanent legal resident for at least five consecutive years.

If you are not 65, you may still be eligible for Medicare Part A if: 

  • You are receiving Social Security disability benefits
  • You have end-stage renal disease (ESRD)
  • You have amyotrophic lateral sclerosis (ALS)

How do I sign up for Medicare Part A?

If you started to receive your Social Security benefits at least three months before your 65th birthday, you do not need to apply for Medicare Parts A or B. You’ll be auto-enrolled and should receive information in the mail before your 65th birthday detailing your benefits.

If you did not start your Social Security benefits at least three months before your 65th birthday, you’ll need to enroll on your own during your Initial Enrollment Period (IEP). Make sure to apply during your first enrollment period as missing this window can result in significantly higher premiums for the rest of your life. 

If you are receiving any other kind of Social Security benefits than regular retirement benefits (such as spousal benefits), you should contact your local Social Security office to see if you will be auto-enrolled in Medicare.

What are the premiums for Medicare Part A?

Medicare Part A is largely funded by a Medicare tax that all people employed in the U.S. and some people stationed outside the U.S. are required to pay. These taxes are taken directly out of your paycheck.

If you or your spouse paid Medicare taxes for 40 quarters (each quarter is approximately 3 months of employment, so 40 credits translates to 10 years of working experience), you won’t have to pay any Medicare Part A monthly premiums. This is usually referred to as “premium-free Part A”.

You are also eligible for “premium-free Part A” at 65 if: 

  • You already get retirement benefits from Social Security or the Railroad Retirement Board
  • You are eligible for retirement benefits from Social Security or the Railroad Retirement Board but have yet to file for them
  • You or your spouse was a government employee in a job that was Medicare-covered

You are eligible for “premium-free Part A” under 65 if:

  • You received Social Security or Railroad Retirement Board disability benefits for more than 24 months
  • You have end-stage renal disease and meet certain requirements

What If I don’t qualify for premium-free Part A?

The amount of money you must pay for your Part A premium is directly related to your length of work history. 

The standard Medicare Part A premium for someone who worked between 30 and 39 eligible quarters maxes out at $240 per month in 2019.

The standard Medicare Part A premium for someone who worked less than 30 eligible quarters maxes out at $437 per month in 2019.

As mentioned above, you can also qualify for premium-free Part A based on the work history of your spouse. The 40 quarter working requirement is the same whether you qualify yourself or under your spouse’s work history.

Related articles: