What Part A costs in 2026
| Your Medicare-taxed work (or a spouse's) | Monthly Part A premium |
|---|---|
| 40 quarters or more | No premium |
| 30 to 39 quarters | $311 |
| Fewer than 30 quarters | $565 |
A premium is only part of the cost. Everyone with Part A pays the inpatient deductible of $1,736 per benefit period in 2026, plus coinsurance for long stays. If you must buy Part A and sign up late, the premium can go up 10% for twice the number of years you could have had it but didn't. See Medicare Part A.
Ohio public employees and the 1986 rule
Many Ohio teachers, school staff, police, firefighters and state and local workers don't pay Social Security tax, but federal law has required state and local employees hired or rehired after March 31, 1986 to pay the Medicare tax. So most Ohio public retirees have enough quarters for premium-free Part A. People who were hired before April 1986 and stayed with the same employer may not have paid the Medicare tax; they may qualify through a spouse or through other jobs, or they can buy Part A.
The retirement systems treat a Part A premium differently:
- OPERS requires Medicare-eligible retirees without premium-free Part A to buy it, and reimburses the premium for eligible retirees (Ohio Revised Code 145.584).
- STRS Ohio requires Part A only if it is available to you without a premium; Part B is required either way.
- SERS tells members who would have to pay for Part A not to sign up for it if they are enrolling in SERS's Medicare coverage, because that plan covers Part A services.
Check your own system's guide before you decide; see Ohio public retirement systems and Medicare.
Help paying Part A
If your income and savings are limited, QMB, one of Ohio Medicaid's Medicare Premium Assistance Programs, pays the Part A premium as well as Part B and Medicare cost sharing. Try the savings programs screener. For help weighing coverage choices, you can request a call from a licensed insurance agent.
Related questions
What does Medicare cost per month in Ohio?
All the monthly pieces.
How much is Part B in 2027?
Where the 2027 amounts stand.
What is IRMAA?
Income-based premiums.
Sources
- Medicare.gov — Medicare costs (Part A premium)
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Social Security — Mandatory Medicare coverage for state and local government employees
- OPERS — 2026 Health Care Program Guide (Part A) (PDF)
- Ohio Revised Code 145.584 — Benefits equivalent to Medicare (OPERS)
- STRS Ohio — Medicare enrollment
- SERS — 2027 Member Health Care Guide (Part A) (PDF)
- Ohio Administrative Code 5160:1-3-02.1 — QMB pays the Part A premium
More questions in this guide
- How do I lower my IRMAA after I retire?
- How much does Medicare cost per month in Ohio?
- How much is Medicare Part B in 2027?
- What is IRMAA and will I have to pay it?
Part of the guide: Medicare costs in 2026 for Ohioans · All questions
Frequently asked questions
I never paid into Social Security at my Ohio public job. Can I get Medicare?
Yes. Medicare eligibility at 65 doesn't depend on Social Security benefits. Public employees hired after March 31, 1986 paid the Medicare tax even without Social Security, and people 65 or older who are U.S. citizens, or lawful permanent residents here at least five years, can buy Part A and Part B.
Can I use my spouse's work record for Part A?
Yes. If your spouse has 40 quarters of Medicare-taxed work, you can get premium-free Part A at 65 based on that record. Divorced spouses married at least 10 years and some widows and widowers can too.
Does Ohio help pay a Part A premium?
Ohio Medicaid's QMB program pays the Part A premium for people with limited income and resources. Separately, OPERS reimburses the Part A premium for eligible retirees who must buy Part A.
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
