Janie Slaven: TONI SAYS: Why is my Medicare premium an extra $506?

May 6—Dear Toni,

My husband, John, and I need your guidance because I believe I have made a mistake enrolling in Medicare. This April, John was laid off from a company he was employed with for more than 20 years and lost his employer health insurance. John is a veteran, receiving his health care from the VA. As his health care is not costing us anything, he did not have to enroll in Medicare.

Since I am turning 65 in July, I have enrolled in Medicare. But am not sure if I enrolled properly, because my Medicare is costing me an extra $506 for Medicare Part A and $164.90 for Medicare Part B. I thought Medicare Part A was free.

I have not worked very much since we married 40 years ago. I was a stay-at-home mom, and I now am the caretaker for John's elderly parents. Please explain what I should do to correct my Medicare mistake. Thank you, Toni.

—Susan from Cleveland

Hello Susan:

Most Americans do not realize that they must work a certain amount of time and pay employment taxes to have Medicare Part A with no premium. This is most likely the cause of your problem.

To qualify for Medicare Part A at no cost, you must have worked and paid Social Security and Medicare taxes from your payroll check for 10 years or 40 quarters. If you paid Medicare taxes for 30-39 quarters, then the standard Part A premium is $278 each month. If you paid Medicare taxes for less than 30 quarters, the premium for Medicare Part A in 2023 is $506 each month.

However, those who do not qualify for premium-free Medicare Part A, but who have been married for 10 years or more to an individual who has met the 10 years/40 quarters requirement, should apply for Medicare under their working spouse's Social Security number. Susan, you should have applied under John's account.

The Toni Says Medicare team's advice to you, Susan, would be to contact your local Social Security office, since it is the government office that enrolls Americans in Medicare. Tell the Social Security representative that you need to appeal your Medicare Part A premium of $506 and that, although you have always been a stay-at-home spouse, your husband worked enough quarters to qualify. So you are seeking premium-free Medicare Part A.

Social Security will look over your husband's Social Security accounts and verify with the IRS that he has enough quarters to qualify for premium-free Medicare Part A. Be prepared to provide a certified marriage license showing you are married. You will have to provide the original certified marriage license, not a copy, to Social Security.

For those Americans who did not work enough to qualify themselves and never married or lived with someone as a domestic partner, they will have to pay for their Medicare Part A premium. For those who were married or had a domestic partner, if the spouse/partner also did not work enough quarters, they will have to pay for their Medicare Part A premium.

What you don't know about enrolling in Medicare WILL hurt you. Chapter 1 of Toni's Medicare Survival Guide Advanced edition can help you avoid problems like Susan's.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.

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