Navigating Medicare enrollment can be complex, especially regarding Medicare Part A. Here’s what you need to know about avoiding Part A premiums and the implications of delaying enrollment.

Is Medicare Part A Mandatory at Age 65?

Medicare Part A covers hospital stays and is generally premium-free for those who qualify. However, enrollment isn’t automatic unless you’re already receiving Social Security or Railroad Retirement Board benefits.

When Enrollment Isn’t Automatic

If you’re employed and not yet claiming Social Security at age 65, enrolling in Medicare Part A is a proactive choice. If your employer has 20 or more employees and offers substantial healthcare coverage, you might decide to delay enrolling in Part A without penalty.

Premium-Free Part A: Are You Eligible?

Medicare Part A typically does not require a premium if you or your spouse paid Medicare taxes for at least ten years (40 quarters). If you don’t meet this requirement, you can buy Part A coverage, but premiums apply:

• $285 or $518 monthly premium in 2025, based on how long Medicare taxes were paid.
• You must also enroll in Medicare Part B if you buy Part A.
• Late enrollment can result in a penalty.

Understanding the Late Enrollment Penalty

If required to buy Part A but delayed beyond your initial enrollment period, your monthly premium increases by 10% for twice the number of years you delayed enrolling.

Avoiding Medicare Part A Premiums

Depending on your circumstances, there are options to avoid premiums at age 65:

Receiving Social Security or Railroad Retirement Board Benefits

• Automatic enrollment at age 65.
• Delay enrollment if you have other creditable coverage (like employer coverage).

Employer Health Plan Coverage

• Companies with 20 or more employees: You may delay enrolling if you have creditable employer health coverage.
• Companies with fewer than 20 employees: Enrollment at age 65 is mandatory.

COBRA Coverage

• COBRA coverage alone does not qualify as creditable coverage when Medicare-eligible.
• Consult experts to understand how COBRA interacts with Medicare.

Social Security Disability Benefits

• Automatic Medicare enrollment after 24 months of disability benefits.
• Delay Part A enrollment if other creditable coverage is available.

VA Health Care Benefits

• VA benefits do not count as creditable coverage for delaying Part A enrollment.
• Enroll in Medicare Part A to cover non-VA facility care and avoid penalties.

Retiree Health Coverage

• Enrollment in Part A may be required by your retiree plan.
• Evaluate your retiree benefits carefully to decide whether delaying Part A enrollment is beneficial.

Secure Your Health Coverage with Plan Medicare

Navigating Medicare can be confusing, but Plan Medicare is here to help. Our expert advisors can guide you through enrollment decisions to avoid penalties and secure optimal coverage.

Call us today at 516-900-7877 or Book an Appointment for personalized advice.

Frequently Asked Questions

Can I Avoid Part A Premiums by Not Enrolling at Age 65?
Yes, under certain conditions such as having employer-provided creditable coverage.

What if I Enroll in Part A Later?
Late enrollment can incur premium penalties unless covered by other creditable insurance.

Are There Risks to Delaying Part A Enrollment?
You risk penalties and coverage gaps if not covered by other creditable insurance.

Should I Enroll in Part A if Eligible for Premium-Free Coverage?
Yes, enrolling is advisable if you qualify for premium-free coverage through Medicare taxes paid.

How Do I Check My Eligibility for Premium-Free Part A?
Contact Plan Medicare for personalized eligibility assistance based on your employment history.