Is Medicare Part B Free if You’re Over 65? Understanding Free Medicare Part B Coverage

Free Medicare Part B: Medicare provides important healthcare coverage for people aged 65 and older, as well as those with certain disabilities. While Medicare Part A (hospital insurance) is usually free for most enrollees, Medicare Part B (medical insurance) typically requires a monthly premium.

So, can you get Medicare Part B for free? In most cases, no, but there are some exceptions. If you qualify for certain assistance programs, you may be able to get help with your Part B premium.

Eligibility for Free Medicare Part B Coverage

Age-based Eligibility: Individuals 65 years or older are automatically eligible for Medicare Part B when they enroll in Medicare. This generally happens automatically, unless you choose to delay enrollment.

Disability-based Eligibility: If you are under 65 and qualify for Medicare due to a disability, you must meet specific criteria set by the Social Security Administration (SSA). The key factors are:

• Duration of Disability: Your condition must be expected to last at least 12 consecutive months.
• Social Security Disability Insurance (SSDI): If you are receiving SSDI benefits, you are automatically eligible for Medicare after a 24-month waiting period.
• Supplemental Security Income (SSI): If you receive SSI benefits based on a disability, you may also be eligible for Medicare.

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Qualifying for Free Medicare Part B

To qualify for free Medicare Part B coverage, you must meet certain criteria based on limited income and assets.

These criteria are part of the Medicare Savings Program that helps low-income individuals pay for their Medicare costs, including Part B premiums.

1. Income-based Eligibility

Income plays a big role in determining if you can get free Medicare Part B coverage. According to Coverright, to qualify, your income must meet certain limits, which are updated every year based on the federal poverty level (FPL) guidelines.

As of November 2023, the income limits for free Part B coverage are:

• For an individual: If your monthly income is $1,640 or $19,683 per year or less, you might qualify for free Part B.
• For a married couple: If your combined monthly income is $2,219 or $26,622 per year or less, you might qualify for free Part B.

What income counts?

Medicare uses something called Modified Adjusted Gross Income (MAGI) to determine your income. This is a more accurate way to look at your financial situation. MAGI includes:

• Adjusted Gross Income (AGI): This is your total income before certain deductions. It includes wages, self-employment earnings, rental income, and investment income.
• Tax-exempt interest: Interest earned on investments that are not taxed, like municipal bonds.
• Non-taxable Social Security benefits: Some Social Security benefits are not taxed and are counted in MAGI.
• Deductions: Certain deductions, such as contributions to retirement plans or student loan interest, are subtracted from your income to calculate MAGI.

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2. Asset-based Eligibility

In addition to income, Medicare also looks at your assets to determine if you qualify for free Part B. Your assets include things like savings, investments, and property.

As of now, the asset limits for free Part B coverage are:

• For an individual: If your assets are $9,090 or less, you might qualify.
• For a married couple: If your combined assets are $13,630 or less, you might qualify.

What counts as an asset?

Not all assets are counted when determining eligibility for free Part B coverage. Some things are excluded from the asset calculation, including:

• Primary residence: The value of your home is not counted.
• Personal belongings: Things like furniture, appliances, clothing, and household items don’t count toward your assets.
• One vehicle: The value of one car is generally excluded from your assets.
• Burial plots: The value of burial plots or funeral arrangements is not counted.
• Life insurance policies: The cash value of most life insurance policies is not counted toward the asset limits.

How the Medicare Savings Program helps?

If you meet both the income and asset limits for eligibility, you may qualify for the Medicare Savings Program. This program can help pay for:

• Your Part B premium.
• In some cases, it can also help pay for your Part B deductible, co-pays, and coinsurance.

Applying for Free Medicare Part B Coverage

To apply for free Medicare Part B coverage, you need to apply through your state’s Medicaid office since Medicare Savings Programs (MSPs) are Medicaid-administered. Your state will determine which program(s) you qualify for.

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You don’t need to have Medicaid to apply for an MSP. Even if you’re unsure about your eligibility, it’s still worth applying as there may be exceptions that allow you to qualify.

For people with limited income, programs like Medicaid or Medicare Savings Programs can assist with Part B premiums, deductibles, and coinsurance. These programs help lower the costs of Medicare for those who qualify.

Medicare Part A, which covers hospital insurance, is typically premium-free for those who or their spouse have worked and paid Medicare taxes for at least 10 years, as per Marca.

Being part of an MSP also automatically makes you eligible for Extra Help (also known as the Low Income Subsidy), a federal program that helps with prescription drug costs for low-income Medicare beneficiaries.