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 up to $413 each month, plus Part B costs. Then, you must also pay coinsurance or copayments for most care.