You qualify for premium-free Medicare Part A if you meet any of these conditions: You’re 65 or older and you or your spouse worked and paid Medicare taxes for at least 40 quarters (10 years). You’re receiving retirement benefits from Social Security or the Railroad Retirement Board. You’re eligible to receive Social Security or Railroad benefits but haven’t filed for them yet. You or your spouse had Medicare-covered government employment.

If you qualify for premium-free Part A, you’ll never pay a premium for it, regardless of when you enroll. There’s no late enrollment penalty for premium-free Part A, and you can sign up anytime after becoming eligible. This differs from Part B, which has specific enrollment periods and penalties.

For those who don’t qualify for premium-free Part A due to insufficient work credits, the 2026 monthly premium is $565 if you have fewer than 30 quarters of coverage or $311 if you have 30-39 quarters. These individuals face a 10% late enrollment penalty that increases their premium permanently if they don’t enroll when first eligible and don’t qualify for a special enrollment period.