You usually don't pay a monthly premium for Part A if you or your spouse paid Medicare taxes for at least 40 quarters 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 only Part A, then you must also pay coinsurance or copayments for most care.