Why Is My Medicare Premium An Extra $471?

Toni:

My husband, John and I need your guidance because I believe I have made a mistake enrolling in Medicare.  Last year, John was laid off due to COVID-19 and has lost his employer health insurance and so I have enrolled in Medicare since I am turning 65 in August. John is a Veteran and is receiving his healthcare from the VA, so he did not have to enroll in Medicare and his healthcare is not costing us anything.

Why is my Medicare costing me an extra $471 for Medicare Part A and $148.50 for Medicare Part B?  I thought Medicare Part A was free.  Is there some form that I did not fill out because I have not worked very much since we married 40+ years ago and was a stay-at-home Mom and now I am the caretaker for our elderly parents? Please explain what I should do to correct my Medicare mistake. Thank you, Susan from Cleveland, Ohio

Susan:

Most Americans do not realize that they must work a certain amount of time and pay taxes to have Medicare Part A at no cost. This is what your problem is and the Toni Says® Medicare office can help you solve your problem.

For you to qualify for Medicare you must have worked and paid Social Security and Medicare taxes from your payroll check.  The Medicare Beneficiary must have worked at least 10 years or 40 quarters (paying taxes) to qualify for Medicare Part A at no additional cost.  When you sign up for Medicare Part A, you may want to enroll in Part B, that also has a monthly premium, if you are not working full-time with yours or your spouse’s employer benefits.

The premium for Medicare Part A is $471 each month if you do not qualify for premium free Medicare Part A. If you paid Medicare taxes for 30-39 quarters not 40 quarters, then the standard Part A premium is $259 each month.

Those who did not work or pay into Social Security System for 10 years and are married such as is your situation Susan, should apply for Medicare under their spouse’s Social Security number to qualify (if spouse worked 10+ years or 40+ quarters). If one never married or possibly lived with someone as a domestic partner and they did not work enough quarters, then they will have to pay for Medicare Part A.

My advice to you Susan would be to call your local Social Security office since it is the government office which overseas America enrolling in Medicare. Explain your situation that you have always been a stay-at-home spouse, your husband has worked enough quarters to qualify and that you need to appeal your Medicare Part A premium of $471. Tell the Social Security representative that you are seeking premium-free Medicare Part A due to your husband having enough quarters to qualify.

Social Security will look over both yours and your husband’s Social Security accounts to verify that he has enough quarters.  Be prepared to provide a certified marriage license showing you are married and will have to mail the original certified marriage license (not a copy) to that specific Social Security office.

For Medicare enrollment questions either call your local Social Security office specific 800 number or call the Toni Says Medicare hotline at 832/519-8664 for help.

Toni King, Medicare author/advocate is giving a $5 discount to the Toni Says® readers on the new 2021Medicare Survival Guide® Advanced book at www.tonisays.com. Have a Medicare question? Call 832/519-8664 or email info@tonisays.com.