If you lack the work history required to be eligible for premium-free Part A, you may not want to pay for hospital insurance because of its high monthly premium. While it is always advisable to have Part A, you can buy Medicare Part B (medical insurance) without having to buy Medicare Part A (hospital insurance) as long as you are:

  1. Age 65+
  2. And, a U.S. citizen or a legal resident who has lived in the U.S. for at least five years

Note, however, that if you do not enroll in Part A when you are first eligible for Medicare and you have to pay a premium for Part A, you can only enroll later if you have a Special Enrollment Period, or during the General Enrollment Period.

If you are willing to pay the Part A premium and choose to enroll in it, you also have to take Part B; you cannot buy Part A alone. If you get Part A premium-free, you can choose whether or not to enroll in Part B.

Finally, state-specific programs exist to help pay Medicare premiums and other costs for beneficiaries with low incomes and assets who are not eligible for premium-free Part A. Some state programs will pay the premium for Part A and will also allow enrollment into premium-free Part A outside the General Enrollment Period. For more information, call your local State Health Insurance Assistance Program (SHIP) and ask if you qualify for this assistance. If you live in New York and have questions about cost-saving programs, call the Medicare Rights Center’s free national helpline at 800-333-4114.