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Who has to pay the Medicare Part A premium?

Medicare | May 12, 2016

Medicare Part A covers medically necessary services - such as hospital care, home health services and nursing home care - required for the treatment of a disease or condition. Most Medicare beneficiaries are eligible to receive premium-free Part A, but there are a few circumstances that would require someone to pay a Part A premium.

"Whether you pay a Part A premium depends on how long you have worked."

The Part A premium for those 65+

Most people become eligible for all facets of Medicare when they turn 65. However, whether you pay a Part A premium depends on how long you paid Social Security taxes. According to Medicare Interactive, you must have worked at jobs for which you paid these taxes for a total of at least 10 years.

There are three other scenarios in which you would be eligible for premium-free Part A. The first is being eligible for Railroad Retirement benefits. The second is anyone who worked as a federal employee after December 31, 1982, and the third is anyone who worked as a state or local employee after March 31, 1986.

What about spouses?

Medicare Interactive explained the work history of your spouse or former spouse can qualify you for a Medicare Part A premium if you satisfy one of the following conditions:

  • You're still married and have been for at least a year
  • You're a widow, were married for nine months or more before the death of your spouse and are still single
  • You're divorced, still single and were married for 10 or more years

The Part A premium for disabled persons

The Centers for Medicare & Medicaid Services laid out two scenarios in which disabled persons become eligible for premium-free Part A:

  • Those with End-Stage Renal Disease that undergo a kidney transplant or receive regular dialysis treatment and are eligible for Railroad Retirement Board or Social Security benefits
  • Those who have been receiving RRB or Social Security disability benefits for two years

There are a few exceptions to these rules. Those with Amyotrophic Lateral Sclerosis do not have to wait for eligibility and may obtain Part A coverage the same month they begin receiving RRB or Social Security benefits. In addition, it is possible for disabled government employees at the state, local and federal level to become eligible for both disability benefits and premium-free Part A after being disabled for 29 months - even if they are not initially qualified to receive any of these benefits.

The cost of the Part A premium

If you are not eligible for premium-free part A, the amount you pay per month will depend on how long you or your spouse paid taxes to Social Security. If it was fewer than seven and a half years, your monthly premium will be $411 for 2016. If it was between seven and a half and 10 years, your monthly premium will be $226 in 2016.

"Part A premiums are not automatically deducted from your benefits checks."

Paying your Part A premium

CMS explained that Part B premiums are automatically deducted from your RRB, Civil Service or Social Security payments. Part A premiums, on the other hand, are not.

When your Part A payment is due, you will receive a "Notice of Medicare Premium Payment Due" every month, and you will be responsible for sending that payment in. You can do so by using Medicare Easy Pay, sending in a check or money order, using your bank's online payment system or filling out your credit or debit card information in the bottom section of the bill and mailing it in.

The rules and exceptions to who must pay the Medicare Part A premium can be rather nuanced. If you are still unsure whether you qualify for premium-free Part A, don't hesitate to contact your benefits provider for more information.