Are Premiums Paid in Advance?

One of the most common questions new Medicare enrollees have is about premium timing — specifically, whether premiums are paid before or after coverage is used. The short answer is that Medicare premiums are generally paid in advance, though how they're billed depends on your situation.

Part A: Is It Free?

Most people receive Medicare Part A (hospital insurance) at no cost, because they or their spouse paid into Medicare through at least 10 years (40 quarters) of work. If you don't have that work history, you can still purchase Part A — but you'll pay a monthly premium, which was $274–$499 per month in 2022 depending on your work history. Purchasing Part A generally requires that you also enroll in Part B.

Part B Premiums Are Non-Optional

Here's something that trips people up: if you enroll in a Medicare Advantage plan, you still owe your Part B premium. Medicare Advantage replaces the way Original Medicare delivers your benefits, but it doesn't replace your Part B obligation. If you stop paying Part B premiums, you lose your Medicare Advantage eligibility. The same rule applies if you have a Medigap (Medicare Supplement) plan — Medigap only kicks in after Original Medicare processes the claim, so Part B must stay active.

How Are Premiums Billed?

If you're receiving Social Security benefits, your Medicare Part B premium is automatically deducted from your monthly payment. Simple and easy — you won't receive a separate bill.

If you're not yet receiving Social Security, Medicare will send you a paper bill. These bills can come quarterly or even up to four months in advance. For example, if your coverage starts January 1st, you might receive a single bill covering three months — roughly $500 at current rates.

Payment Options

• EasyPay — Free automatic deduction from your bank account, processed around the 20th of each month
• Medicare.gov online account — Pay directly through your Medicare account
• Mail a check — Payable to "Medicare Premium Collection Center"

Payments are due by the 25th of the month. If you're mailing a check, submit it by the 20th to allow processing time.

Don't Let Premiums Lapse

Missing premium payments can have serious consequences — including losing coverage. If you're unsure about your premium obligations or want to understand all your out-of-pocket costs, a licensed agent can walk you through the numbers before you enroll.