Toni Says: Why Is My Medicare Premium an Extra $506?


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 20+ years and lost his employer health insurance. 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.

I have enrolled in Medicare since I am turning 65 in July 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 now, I am the caretaker for John’s elderly parents. Please explain what I should do to correct my Medicare mistake. Thank you, Susan from Cleveland, Ohio

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 and the Toni Says® Medicare team can help you resolve this issue.

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 (paying taxes). If you paid Medicare taxes for 30-39 quarters not 40 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 is $506 each month.

However, those who did not work or pay into the Social Security System for at least 10 years or 40 quarters but have been married for 10 years or more to an individual who has met these requirements, should apply for Medicare under their working spouse’s Social Security number. Susan, you should have applied under John’s account.

My advice to you Susan would be to contact your local Social Security office, since it is the government office which enrolls America in Medicare. Explain to Social Security that you have always been a stay-at-home spouse, but your husband has worked enough quarters to qualify. Tell the Social Security representative that you need to appeal your Medicare Part A premium of $506 because you have always been a stay-at home spouse and that your husband worked enough quarters to qualify for Medicare. So, you are seeking premium-free Medicare Part A and need help to do that.

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.

If one did not work enough quarters or is married to a spouse that did not work enough quarters, they will have to pay for their Medicare Part A premium. Don’t forget how important working and paying taxes for 40 quarters is to enroll in Medicare!

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.

Have a Medicare question, call the Toni Says Medicare hotline at 832/519-8664 or email at

Toni’s book “Medicare Survival Guide Advanced” edition is offering a $10 discount available to Toni Says® readers and their friends at and Visit to listen to Toni’s Medicare Moments podcasts.