During your working years, you pay 1.45% of each paycheck (and that amount is matched by your employer) to pay for Medicare Part A. You earn “premium free” Part A by contributing to the Medicare program for 40 quarters (the equivalent of 10 years) or being married to someone who has. Individuals who did not contribute to the Medicare program for the required length of time can purchase Part A directly from the government.
Generally, Medicare Part A starts automatically when you turn 65 if you’re already receiving Social Security. If you’re not yet receiving Social Security at age 65, you can sign up for Medicare Part A at your local Social Security office. Individuals who have been on Social Security Disability for two years or who have been diagnosed with End-Stage Renal Disease (ESRD) can also qualify for Medicare Part A.
About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.
Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to voluntarily enroll in Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $259 in 2021. Certain uninsured aged individuals who have less than 30 quarters of coverage and certain individuals with disabilities who have exhausted other entitlement will pay the full premium, which will be $471 per month.