Medicare Parts A and B

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Program Basics

  1. Healthcare Eligibility
  2. Paying for Coverage
  3. Manage Your Enrollment
  4. Medicare
    1. Eligibility and Enrollment
    2. Parts A and B
    3. Premium Reimbursement
    4. Part D Solicitations
  5. Healthcare Resources
  6. Healthcare Legislation
Begin content

Part A: Hospital Coverage, Cost, and Eligibility

Medicare Part A is hospital insurance. It covers inpatient hospital care and surgery as well as skilled nursing facility, hospice, and home healthcare.

Medicare Part A is free to any person age 65 or older who is either:

  • Eligible to receive a monthly Social Security benefit, or
  • Eligible based on wages in which sufficient Medicare payroll taxes were paid.

You automatically apply for Medicare Part A when you apply for Social Security benefits. Your spouse may also qualify for Part A coverage at age 65, based on your eligibility for Social Security. If you are not eligible for free Part A coverage, you may purchase it.

For those not eligible for free coverage, the 2025 Medicare Part A premium amount is $285 or $518 per month, depending on how long you or your spouse worked and paid Medicare taxes. See current income limits and premium amounts on the Medicare website.

Medicare Part A is free to any person under age 65 who is disabled and has either:

  • Received Social Security disability benefits for 24 months as a worker, surviving spouse, or adult child of a retired, disabled, or deceased worker; or
  • Accumulated a sufficient number of Social Security credits to be insured for Medicare and meets the requirements of the Social Security disability program.

For questions about eligibility for enrollment in Medicare Part A, contact Social Security directly.

Part B: Healthcare Coverage and Premium Structure

Part B Supplemental Medicare Insurance covers physician, lab, testing, and other costs. When you enroll in Medicare Part A, you are automatically enrolled in Medicare Part B unless you decline it. This rule applies to people age 65 or older and to those who are disabled under age 65. 

If you pay a premium for Plan A, you must enroll in Part B if you also desire that coverage. Part B coverage is ordinarily deducted from your Social Security benefit.

The standard Medicare Part B monthly premium amount for 2025 is $185.

If you select a LACERA-administered Medicare plan, the County may reimburse you for the Part B premium amount. This reimbursement program is subject to annual review by the Board of Supervisors.

If your modified adjusted gross income (MAGI) as reported on your IRS tax return from the previous two years is above a certain amount, you'll pay the standard premium amount plus an income-related monthly adjustment amount (IRMAA), an extra charge added to your premium. See a chart with current income limits and premium amounts on the Medicare website to see if you are subject to an IRMAA, or contact Social Security for more information.

Combination Coverage

If you are currently enrolled in Medicare Part A and Part B and your dependent is not, or vice versa, you will need to enroll in corresponding LACERA-administered health plans. See more below.

Medicare Advantage Prescription Drug Plans (MA-PD)
LACERA-Administered Medicare PlanCorresponding Non-Medicare Plan
Cigna Preferred Medicare with Rx
(available in Maricopa County and Apache Junction, Pinal County, Arizona only)
Cigna Network Model Plan
Kaiser Senior AdvantageKaiser
UnitedHealthcare Medicare AdvantageUnitedHealthcare
SCAN Health PlanNONE

Medicare Supplement Plan

Anthem Blue Cross Plan III

Anthem Blue Cross Plan I OR Anthem Blue Cross Plan II

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