Most people don’t have to pay a monthly premium for Medicare Part A. If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), you qualify for what’s called premium-free Part A. But if you don’t meet that requirement, you may need to buy it.
In 2026, the monthly premium for Part A is either $311 or $565, depending on how long you or your spouse paid Medicare taxes. If you worked 30 to 39 quarters, the premium is $311. If you worked fewer than 30 quarters, the premium is $565.
If you buy Part A, you usually must also enroll in Part B and pay the monthly premium for both. The standard Part B premium in 2026 is $202.90 per month.
If you decide not to buy Part A, you can still get Part B as long as you’re eligible. But if you delay signing up for Part A and later decide to enroll, you could face a penalty that raises your premium by 10 percent. You’ll have to pay the higher premium for twice the number of years you delayed enrollment.
If you have limited income and resources, help is available. Many people qualify for state assistance programs that help pay for Medicare premiums and other costs.