Is Medicare Free?

A portion of the payroll taxes you pay throughout your working career are set aside in a trust fund to help pay for Medicare Part A. If you or a spouse contribute to Medicare taxes for a minimum of 40 quarters (10 years) in the U.S., then your Medicare Part A benefits will have a $0 monthly premium.

Beneficiaries who contribute 30-39 quarters will have a monthly premium of $311. Those with fewer than 30 quarters of contributions would pay the full premium, which is $565 in 2026.

While the premium for Part A may be $0 in some cases, you are still responsible for deductibles, copayments and coinsurance when receiving care.

Medicare Part B is not free. Most Medicare Part B enrollees have a standard monthly premium that can change from year to year. For 2026, the standard monthly premium is $202.90, up from $202.90 in 2025.

Premiums reflect income. Therefore, if you’re in a higher income bracket, you will pay more for coverage, this is known as IRMAA.

In addition to your premium, Medicare Part B also requires you to pay a deductible, copayments, and coinsurance each time you use your benefits.

While some Medicare Advantage plans do have a $0 premium, this does not mean the coverage is entirely “free”. When enrolled in Medicare Advantage, you will still need to pay your Medicare Part B premium.

There are both pros and cons of Medicare Advantage plans. They may offset the zero-dollar premiums by requiring higher copayments and coinsurance. They also tend to have higher out-of-pocket costs than Medigap Plans.