Premium-Free Medicare Part A for Non-Working Spouses


Your Medicare coverage doesn’t cover your spouse. Medicare beneficiaries who need health-care coverage need to receive their own Medicare insurance. However, this is a little different when it comes to eligibility and enrollment for premium-free Medicare Part A.

Most people who are eligible for Medicare don’t pay a monthly premium for Medicare Part A (hospital insurance) if they or their spouses paid Medicare taxes while working. If you or your spouse has worked at least 10 years (or 40 quarters) in Medicare-covered employment, then premium-free Part A is available to both of you. If you don’t have enough work quarters to qualify for premium-free Part A through your own work history, you may be able to qualify through your spouse. Note that you’ll both have to separately enroll in Medicare, but neither of you would have to pay a monthly premium for Part A. 

There may be situations when you have a non-working spouse who will turn 65 before you. If you are at least age 62 and worked at least 10 years (or 40 quarters) in Medicare-covered employment, then your spouse is eligible to receive premium-free Medicare Part A once he or she turns 65.

However, if you are not yet age 62 at the time your spouse turns age 65, then he or she cannot get premium-free Part A until you reach age 62. Your spouse can still enroll in Part A at age 65 and pay a premium for it, which will vary depending on long he or she worked and paid Medicare taxes. (Remember, you may owe a late-enrollment penalty for Part A if you must pay a premium for it and don’t sign up when you’re first eligible.) Once you turn 62, your spouse can qualify for premium-free Part A based on your work history.

How much you pay for Medicare Part A

Those who do have to pay a premium for Medicare Part A will pay up to $411 in 2016 each month. As mentioned above, 10 years or 40 quarters results in premium-free Part A for most beneficiaries, but those who haven’t worked 40 quarters may need to pay out of pocket for their Part A premiums.

  • People with 30 to 39 quarters of Medicare-covered employment pay a monthly premium of $226 in 2016.
  • Those with less than 30 quarters of Medicare-covered employment and who are not eligible for free or reduced Medicare premiums for any other reason pay a monthly premium of $411 in 2016. 

How Social Security and Medicare taxes are calculated and withheld together as a federal tax

The taxes you pay while working that eventually qualify you for premium-free Medicare Part A come from the Federal Insurance Contributions Act (FICA). This tax law takes a percentage from paychecks and income, putting these subtractions toward the Social Security and Medicare programs.

The taxes have different rates, but both employers and employees must share the FICA payments as described below.

  • The Social Security tax rate is 12.4%, split between the employer and employee with a rate of 6.2% for each (self-employed people are responsible for paying the 12.4% themselves).
  • The Medicare tax rate is 1.45% for the employer and 1.45% for the employee, or 2.9% total.

There are many Medicare options available, and it’s normal for you to have questions. If you need help getting answers, feel free to give eHealth a call to speak with a licensed insurance agent about your coverage needs. Or, if you prefer, you can view Medicare plan options in your area right from your home; just enter your zip code into the plan finder tool on this page to get started.

To learn about Medicare plans you may be eligible for, you can:

  • Contact the Medicare plan directly.
  • Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
  • Contact a licensed insurance agency such as Medicare Consumer Guide’s parent company, eHealth.
    • Call eHealth's licensed insurance agents at 888-391-2659, TTY users 711. We are available Mon - Fri, 8am - 8pm ET. You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.
    • Or enter your zip code where requested on this page to see quote.

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