You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes while you were working.

You can get Part A without a premium if:

• You already get a Social Security or Railroad check for retirement.
• You're eligible to get Social Security or Railroad benefits, but haven't filed for them yet.
• You or your spouse had Medicare-covered government employment.

Usually, if you choose to buy Part A, you must also have Part B. If you buy Part A, you'll pay a premium each month, plus Part B costs. Then, you must also pay coinsurance or copayments for most care.