I had worked 40 years for the Los Angeles Healthcare system which had opted out of Social Security. My total quarters credited for Social Security are 14 and counting as I retired out of LA County and work now as a self-employed consultant. My county retirement package includes great medical coverage. After I signed up for Medicare Parts A and B my bill for Part B was around $500 per month so I asked SS if I could drop Part B and they told me I could. Now I have gotten a letter telling me I can’t drop Part B because I don’t have “free Medicare Part A” and they consider me “uninsured”. Can you translate that and tell me if they are correct? Thank you very much!

Hi. Unless you qualify for premium free Part A of Medicare based on your or your spouse's Social Security insured status, you have to pay a monthly premium to get Part A coverage. If you haven't had at least 40 quarters (QC) of Social Security or Medicare covered work, then the only way that you could qualify for premium-free Part A coverage is based on a spouse's insured status. Your spouse would need to be at least age 62 or drawing Social Security disability benefits, and they'd need to have a minimum of 40 QCs of Social Security or Medicare covered work.

The monthly Part A premium for people who don't qualify for premium-free coverage is currently $471, unless the person or their spouse has 30-39 QCs in which case the premium amount is $259 (https://www.medicare.gov/your-medicare-costs/part-a-costs). The base monthly premium for Part B of Medicare is only $148.50 at present, although it can be as high as $504.90 for people with high incomes.

I don't know what your actual status is based on what you've stated, but if what Social Security is telling you is correct then you must be paying a monthly premium to have Part A coverage. And, if you must pay a premium for Part A coverage then you're required to also have Part B coverage and pay the premium for that. The alternative would be to drop both Parts A & B of Medicare, but whether or not you'd want to do that likely depends on your other health insurance through your former employer. I would suggest that you discuss your options with a representative of the company that administers the health insurance plan from your work for the county.

Best, Jerry