Is Medicare free? Is Part A free?
Part A has no premium for most people, which is not the same as free. Here is every charge Medicare still sends your way.
No. Medicare is not free, and the belief that it is causes more budget surprises at 65 than anything else in the program.
What is true is that Part A usually has no monthly premium. People hear that and reasonably assume the rest follows. It does not.
Why Part A has no premium
You prepaid it. Every paycheck of your working life had a Medicare tax taken out. Once you or your spouse accumulate about 10 years of that, Part A comes with no monthly bill.
If you did not reach that work history, you can still buy Part A, and it carries a real monthly premium. This comes up most often for people who spent their careers outside the United States, which is not rare in South Texas.
What you still pay even with premium free Part A
- A Part A deductible each time you start a new benefit period in the hospital, not once a year
- Daily coinsurance if a hospital stay runs long
- Daily coinsurance for skilled nursing after the first stretch of days
Premium free means no monthly bill. It does not mean no bill.
Everything else has a price
- Part B has a monthly premium nearly everyone pays, plus its own annual deductible, plus 20 percent of most services with no ceiling
- Part D has a monthly premium, a deductible and copays that vary by drug tier
- A Medigap policy has a monthly premium
- A Medicare Advantage plan may have no additional premium, but has copays and an out of pocket maximum
Add it up and most people spend a meaningful amount each month. See the full cost breakdown.
Where zero dollar actually shows up
Two things are genuinely free, and both get overlooked.
- Preventive services under Part B, when you use a provider who accepts assignment. Screenings, vaccines and the annual wellness visit cost you nothing.
- Many Medicare Advantage plans in Hidalgo County carry no premium beyond the Part B premium you already pay.
A zero dollar premium Advantage plan is not free coverage. You still pay your Part B premium every month, and you pay copays when you use care. What it removes is the extra monthly bill, not your costs.
How it actually becomes close to free
For people with limited income there are programs that can drop the cost to almost nothing, and they are underused around here.
- Medicare Savings Programs can pay your Part B premium outright, which puts that money back into your Social Security check
- Extra Help, also called the Low Income Subsidy, cuts prescription costs sharply
- Full dual eligibility with Medicaid can leave you paying very little for anything
It costs nothing to check whether you qualify, and the income limits are higher than most people assume. Read how Medicare and Medicaid work together in Texas.
Common follow-up questions
I paid into Medicare my whole life. Why is there a Part B premium?
Payroll taxes fund Part A. Part B has always been a separate voluntary program funded partly by premiums and partly by general revenue.
Can I refuse Part B to avoid the premium?
You can, but unless you have coverage from active employment you will face a permanent penalty and a delay when you want it back. See the late enrollment penalty.
Is a zero premium Advantage plan really zero?
The plan charges no additional monthly premium. You still pay Part B, and you pay copays as you use care.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. No cost to talk it through.
Call (956) 687-3334Read next
Medicare Annual Enrollment in South Texas: dates, rules and what to do
Medicare