Many questions come to mind as someone approaches Social Security and Medicare. Among those questions, when to start Social Security benefits and Medicare are at the forefront. Medicare eligibility requires individuals to be US citizens or permanent US residents.

Most Americans will have premium-free Medicare Part A due to working for 10 years or 40 quarters and paying Medicare taxes. Suppose you didn’t satisfy this requirement but had a spouse that did. In that case, you can qualify for premium-free Part A from spousal and survivor benefits. Today, we’ll discuss how Social Security impacts Medicare and vice versa.

The Impact of Social Security on Medicare

More seniors are pushing back their retirement and working past 65. Individuals can start their Social Security as early as 62. Still, most people don’t have the full retirement age until 66 to 67. Those who take Social Security before the full retirement age receive a lower benefit.

For most people starting Medicare before 65 isn’t an option. However, people with certain health conditions and disabilities can get Medicare earlier. When it comes to it, it’s not necessary to draw Social Security to enroll in Medicare health insurance, but it can make the process smoother.

Do I have to take Medicare when I take Social Security?

Since the full retirement age is after the age of Medicare eligibility, many Medicare beneficiaries start Medicare before Social Security. This enrollment occurs online at www.ssa.gov, in person at your local Social Security office, and sometimes over the phone. Once enrolled, most will receive a quarterly bill for their Medicare Part B premiums.

Many beneficiaries who continue to work past their 65th birthday can delay their Medicare Part B without a penalty since they have a creditable group plan through their employer. These beneficiaries can still take their Medicare Part A hospital insurance.

If you’re not drawing Social Security benefits, it’s recommended that you start the process three months before your 65th birthday. This extra time allows for additional information to be requested and provided and ensures you have a painless transition to Medicare.

Is Social Security and Medicare the same account?

Some Americans will enroll in both Medicare and Social Security at the same time, as stated above, doing this three months before the birth month of your 65th birthday is best. The only benefits of taking Social Security and Medicare simultaneously are as follows:

  • One application for SSI and Medicare
  • Automatic monthly deductions from your Social Security benefits check for your Part B premium.

What happens if I miss my enrollment in Medicare?

Suppose you miss your Initial Enrollment Period (IEP) for Medicare. In that case, you could be penalized for Medicare Part A, Part B, and Part D.

Unless you have creditable coverage outlined by the Centers for Medicare & Medicaid Services, suppose you don’t have a Special Enrollment Period (SEP) due to leaving credible coverage. In that case, you won’t be able to enroll until the General Enrollment Period (GEP).

If you miss your enrollment window and don’t have creditable healthcare coverage, you expose yourself to healthcare issues without medical insurance.

Do you automatically get Medicare with Social Security?

Enrolling in Medicare will be automatic for beneficiaries who started the Medicare Program early due to qualifying medical conditions or Social Security disability (SSDI). Automatic enrollment also applies to those who began their Social Security retirement benefits before age 65.

When an individual has a qualifying medical condition like amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease) or reaches their 25th month of disability, their Medicare Part A and Part B will begin automatically. For those drawing retirement benefits early, their Medicare coverage will start the 1st of the month they turn 65.

FAQs

What is the Income Related Monthly Adjustment Amount (IRMAA)?

Higher-income beneficiaries may have to pay a higher premium for their Medicare Part B medical insurance and Medicare Part D prescription drug coverage. The IRMAA is based on income tax returns from the previous two years.

What happens if I can’t afford the Medicare premiums?

Several programs available from the state and federal governments can assist low-income beneficiaries with their Medicare costs. The Extra Help program will assist lower-income beneficiaries with their Part D prescription drug plan premiums and copays. Medicare Savings Programs can assist with paying the premiums and out-of-pocket Medicare costs.

What should I consider as Medicare AEP approaches?

As we approach AEP, it’s essential to review your Annual Notice of Coverage (ANOC) to see what changes are affecting your current plan.

Even if you feel like the changes are going to work for you, it’s recommended that you review your prescription drug coverage. Since programs change yearly, not checking your options could cost you more for your health plan.

How to find out about the new plan options for AEP?

We’d love to help. Our insurance agents can view all the plans available and specialize in Medicare. Let us help review the top Medicare Supplement, Medicare Advantage, and Part D prescription drug plans with your situation, doctors, and prescriptions to ensure you’re getting the best plan for your situation.

Simply give us a call, or fill out our online request form.

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by Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.