Most Medicare enrollees do not pay a premium for Part A (hospital insurance) coverage. This is possible through Medicare taxes, which are deducted automatically from your paycheck every pay period. 

When you qualify for free coverage through Medicare Part A, the government counts how many calendar quarters (3 months) you paid into the Medicare system through payroll taxes. It does not matter the amount you paid as long as you have enough payments recorded.

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Requirements to Qualify for Free Coverage

As of 2022, you may qualify to enroll in Medicare Part A for free if you paid Medicare taxes for 40 quarters. This is the equivalent of paying Medicare taxes for just 10 years.

However, even if your taxes contributed to the Medicare programs for less, you can enjoy Part A coverage for less than you would normally pay. For example, if you paid into Medicare for 30 to 39 quarters (7.5 to 9.75 years), you can pay a reduced amount of $274 each month for Part A coverage. 

If you paid into Medicare for less than 30 months, you will need to pay the full amount for Part A coverage. In 2022, this amount is $499.

If you receive benefits from Social Security or Railroad Board, your premium is automatically subtracted from your payments.  

You may still be able to qualify for Medicare coverage, even if you do not meet the tax requirements for reduced or free premiums. You will be responsible for any costs associated with coverage. 

Your premium amount for Part B, C or D may increase if you do not sign up when you first qualify. Find out when to enroll to avoid these late enrollment penalties.

Updated on 05/25/2022