How do Social Security and Medicare work together?

How do Social Security and Medicare work together?

They are separate programs, but the Social Security Administration handles enrollment and collects premiums for many on Medicare. Although Social Security and Medicare are distinct programs for older and disabled Americans, they have a key connection: the Social Security Administration (SSA) plays a significant role in Medicare enrollment and premium collection.

Specifically, the SSA partners with the Centers for Medicare & Medicaid Services (CMS) to manage the enrollment process for Medicare Part A (hospital insurance) and Part B (medical insurance). This involves informing eligible individuals about their sign-up options, processing their applications, and collecting premiums.

For most individuals turning 65 who are already receiving Social Security retirement benefits, the SSA will automatically send a Medicare enrollment package about three months before their 65th birthday. Enrollment in Part A and Part B is generally automatic upon their 65th birthday. While individuals have the option to opt out of Part B, doing so and enrolling later may result in permanently higher premiums.

Those not yet receiving Social Security benefits need to apply for Medicare independently during their initial seven-month enrollment period, which starts three months before their 65th birthday. Failure to enroll during this time could also lead to late enrollment penalties. Comprehensive information on enrollment can be found in the SSA's "Medicare" publication and on their website.

Regarding premiums, if someone receives Social Security benefits, their Medicare Part B premiums are typically deducted directly from their monthly payments. Those not receiving benefits will receive premium bills from CMS. It's important to note that most Medicare beneficiaries don't pay premiums for Part A due to sufficient work history and Medicare tax contributions. In 2025, the standard Part B premium is $185 per month, but this amount can be higher based on the beneficiary's income, as determined by the SSA using income information from the IRS.

It's also worth noting that individuals with disabilities receiving Social Security Disability Insurance (SSDI) are generally automatically enrolled in Medicare Parts A and B after receiving benefits for two years. Furthermore, individuals enrolled in Medicare Part D (prescription drug plan) or a Medicare Advantage plan (Part C) can often choose to have those premiums deducted from their monthly Social Security payments.

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