Is Medicare free at 65?
No. Part A is premium-free for most people who worked and paid Medicare taxes for at least 40 quarters, but Part B carries a premium — $202.90 a month in 2026 — along with deductibles and coinsurance that continue for as long as you are covered.
- Part A is usually premium-free with 40 quarters (about 10 years) of Medicare-taxed work.
- Part B costs $202.90 a month in 2026, plus a $283 annual deductible.
- Original Medicare pays roughly 80% of approved costs after the deductible, with no annual cap on your 20%.
- Part D drug coverage, a Supplement, or a Medicare Advantage plan may each add further costs.
What is actually free, and what is not
Part A — inpatient hospital care, skilled nursing, hospice — is premium-free if you or a spouse paid Medicare taxes for at least 40 quarters. That is the part of Medicare people are thinking of when they call it free. It still has a deductible for each benefit period, and coinsurance for long stays.
Part B is not free for anyone. The standard premium is $202.90 a month in 2026, and it is usually deducted from a Social Security payment rather than billed — which is why some people do not notice they are paying it. On top of the premium there is a $283 annual deductible, and then the 20% coinsurance on most services.
The part that surprises people
Original Medicare has no annual out-of-pocket maximum. The 20% you owe after the deductible keeps going, however large the bill. On an ordinary year that is manageable; on the year of a serious illness it is not, and that open-ended exposure is the specific problem both Medicare Supplement plans and Medicare Advantage plans exist to solve — in opposite ways. A Supplement pays the gaps in exchange for a monthly premium; an Advantage plan caps your spending in exchange for a network and copays.
If the premiums are a genuine problem
Help exists and it is under-claimed. Medicare Savings Programs can pay the Part B premium for people under certain income and asset limits, and Extra Help (the Part D Low-Income Subsidy) can substantially reduce drug costs and removes the Part D late-enrollment penalty entirely. In Utah, Medicare Savings Programs are administered through the Department of Workforce Services. Call Sarah, a licensed insurance agent, at 435-292-8777 (TTY 711) and she will check whether you qualify; it costs nothing to find out.
Sources
- Medicare.gov — costs and enrollment U.S. Centers for Medicare & Medicaid Services
- CMS 2026 Medicare Parts A & B premiums and deductibles Centers for Medicare & Medicaid Services
Run the numbers yourself
IRMAA estimator
See whether your income adds a surcharge to your Part B premium — and how much.
Advantage vs Medigap cost
Compare what each path could cost you in a typical year — and in a tough one.