Who gets premium-free Part A, and what it costs if you don't qualify
The 40-quarter work rule, spouse and survivor routes, the 2026 Part A premiums for people with fewer quarters, and the late penalty for buying Part A.
Most people pay nothing for Part A because they or a spouse paid Medicare taxes for at least 40 quarters (about 10 years of work).
If you have fewer quarters
| Work quarters | 2026 Part A premium |
|---|---|
| 40 or more | $0 |
| 30 to 39 | $311 a month |
| Under 30 | $565 a month |
Other ways to qualify for free Part A
- On a current, divorced or late spouse's record; see Part A on a spouse's record.
- After 24 months of Social Security disability benefits; see Medicare on SSDI.
- With end-stage renal disease or ALS.
The Part A late penalty
If you must buy Part A and don't sign up when first eligible, the premium can rise 10% for twice the number of years you delayed.
Help paying
The Qualified Medicare Beneficiary program pays Part A premiums for people with limited income and resources; see Medicare Savings Programs.
Questions people ask
How many quarters do I need for free Part A?
40 quarters, about 10 years of work.
What does Part A cost without enough quarters?
$311 or $565 a month in 2026.
Can I use my spouse's record?
Yes, under Social Security's spouse rules.
Is there a Part A late penalty?
Yes, for people who must buy Part A and delay.
Independent educational site. Not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any insurance company. Figures are 2026 amounts published by CMS unless noted; check Medicare.gov for your situation.