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No, Medicare is optional, but enrolling at age 65 is recommended for those who lack other credible healthcare coverage. For veterans, Medicare can be beneficial even if you have VA benefits, as it covers services outside the VA network. Spouses of veterans may also need Medicare to avoid potential penalties and access broader coverage.

Medicare Part A is typically premium-free if you or your spouse paid Medicare taxes while working. Part B has a standard monthly premium, which can vary based on income. Other parts, like Part D or Medicare Advantage, may involve additional premiums.

Yes, but delaying Medicare without other qualifying coverage (like employer insurance) may lead to lifelong penalties for Part B and Part D. Veterans with VA health benefits may still benefit from enrolling to access care outside the VA, and spouses should consider this when planning.

Certain Medicare Advantage plans offer a "giveback" benefit that rebates part or all of your Part B premium. Eligibility depends on your location and the specific plan you choose. Veterans and their spouses interested in this option should compare local Advantage plans to find those offering premium rebates.