Who can buy Part A?
People without enough work quarters for premium-free Part A can buy "premium Part A" if they meet all of these:
- You're 65 or older.
- You live in the United States (for Medicare, that includes Puerto Rico).
- You're a U.S. citizen, or a lawful permanent resident (green card holder) who has lived in the U.S. continuously for the 5 years before you apply.
- You have Part B or enroll in it. You can't buy Part A by itself.
What it costs in 2026
| Your situation | Monthly premium |
|---|---|
| Part A, never worked in the U.S. (fewer than 30 quarters, yours or a spouse's) | $565 |
| Standard Part B premium, which you also pay | $202.90 |
Before you pay, check whether you qualify without a premium on your spouse's record: if your husband or wife has 40 quarters of Medicare-taxed work, you can get premium-free Part A. Some divorced and widowed spouses can too. See do I have to pay for Part A?
When to sign up
- Use your Initial Enrollment Period. It's 7 months around your 65th birthday: the 3 months before, your birthday month and the 3 months after.
- If that's passed, use the General Enrollment Period. January 1 to March 31 each year; coverage starts the next month.
- Avoid penalties. If you buy Part A late, the premium can go up 10% for twice the number of full years you delayed, and Part B has its own penalty.
The 2025 law on immigrants and Medicare
A federal law signed July 4, 2025 limits Medicare to U.S. citizens and nationals, lawful permanent residents, people with Cuban and Haitian entrant status, and certain residents under the Compacts of Free Association. For people who already had Medicare when the law was signed and aren't in those groups, Social Security and CMS say coverage continues through January 31, 2027 and ends February 1, 2027, and Social Security must notify them. The law doesn't change the rule for buying Part A without a work record: citizenship, or permanent residence with 5 straight years. See the 2027 changes for immigrants and Medicare for permanent residents in Florida.
Help paying in Florida
QMB, one of the Medicare Savings Programs decided by the Department of Children and Families (DCF), can pay the Part A and Part B premiums if your income and assets are limited. These programs have their own rules for immigrants; DCF decides each case through ACCESS Florida. See Medicare Savings Programs in Florida. For help comparing coverage choices, you can request a call from a licensed insurance agent.
Related questions
Do I have to pay for Part A?
The 40-quarter rule.
What does Medicare cost per month in Florida?
All the monthly pieces.
What is IRMAA?
Income-based premiums.
Sources
- eCFR — 42 CFR 406.20, requirements to buy premium Part A
- eCFR — 42 CFR 407.10, who can enroll in Part B
- eCFR — 42 CFR 406.32 and 406.33, Part A premiums and late-enrollment increase
- eCFR — 42 CFR 400.200, definition of United States (includes Puerto Rico)
- Public Law 119-21 (July 4, 2025), section 71201, limiting Medicare coverage of certain individuals
- Medicare.gov — Medicare costs (to buy Part A you must also sign up for Part B)
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Florida DCF — ESS Program Policy Manual, Chapter 2000 (QMB)
More questions in this guide
- Do I have to pay a premium for Medicare Part A?
- Will selling my home up north before moving to Florida raise my Medicare premiums?
- How do I lower my IRMAA after I retire?
- How much does Medicare cost per month in Florida?
- What is IRMAA and will I have to pay it?
Part of the guide: Medicare costs in 2026 for Floridians · All questions
Frequently asked questions
Can I get only Part B, without buying Part A?
Yes. People 65 or older who are citizens, or permanent residents with 5 straight years in the country, can enroll in Part B alone. They won't have Medicare hospital coverage.
Does work I did in Cuba, Venezuela or another country count?
Quarters for premium-free Part A come from work where U.S. Medicare taxes were paid. Work in Puerto Rico counts. If you worked in another country, ask Social Security whether any agreement with that country applies to you.
When does coverage start if I sign up in the General Enrollment Period?
The General Enrollment Period runs January 1 to March 31. If you sign up then, coverage starts the first day of the month after you enroll, and you may owe late enrollment penalties.
Medicare in your Florida county
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