Medicare and Social Security are separate federal programs that serve older and disabled Americans. However, the agencies that administer these programs work together to perform two key functions when it comes to Medicare: enrollment and collecting premiums.

It’s important to understand how Social Security and Medicare work together so you know who to contact with questions about benefits, enrollment and other services.

Here is everything you need to know.

What is Medicare?

Medicare is the largest health insurance program in the country, covering more than 66 million older Americans and some younger people with disabilities. The U.S. Centers for Medicare & Medicaid Services (CMS) oversees the federal program, which is primarily for people ages 65 and older, but also covers some younger people who have collected Social Security Disability Benefits (SSDI) for at least 24 months.

Original Medicare, which is administered by the federal government, includes Part A and Part B. Original Medicare covers hospital stays, doctor visits, durable medical equipment, home health care and other medical services. Most people don’t pay a monthly premium for Part A since they paid into the program via payroll taxes, but Part B does charge a monthly premium, $174.70 in 2024.

Medicare Part D is prescription drug coverage administered by private health insurance companies, and it serves as a supplement to Original Medicare.

Medicare Part C, better known as Medicare Advantage, is an alternative to Original Medicare. It’s provided by private insurance companies and bundles features of Part A, Part B and usually Part D drug coverage into a single plan.

Medicare doesn’t cover all medical and drug costs, however. There are also deductibles, monthly premiums and coinsurance amounts that beneficiaries are responsible for paying.

What is Social Security?

Social Security is a program run by the federal government that provides income for a wide range of Americans, including retirees, people with disabilities and families with a deceased spouse or parent. All of the programs are overseen by the Social Security Administration (SSA).

When you work and pay Social Security taxes, you earn credits towards retirement benefits. Most workers need at least 40 credits — or 10 years of work — to be eligible for benefits.

The size of a retirement benefit is calculated using a formula based on how much money you paid into the program during your working years as well as what age you start collecting Social Security.

Once you turn 62 years old, you can start collecting monthly payments that replace a portion of your pre-retirement income. However, claiming benefits prior to your full retirement age (age 67 for those born in 1960 or later) will result in a lower lifetime benefit amount. Here’s the best time to start collecting Social Security to maximize your benefits.

How Medicare and Social Security work together

Most people who are enrolled in Medicare also receive Social Security benefits. However, it’s possible to be enrolled in one program, but not the other.

The SSA works with CMS to notify older Americans about their initial Medicare enrollment period, process their applications and collect premiums. So, you’ll likely interact with the SSA quite a bit around the time you first sign-up for Medicare and, for most people, your monthly Medicare Part B premium will be automatically deducted from your Social Security check. Aside from that, SSA doesn’t interact much with Medicare beneficiaries.

Here’s a closer look at the role Social Security plays in Medicare.

Social Security manages Medicare enrollment

Medicare eligibility begins for most people at age 65. If you’re already collecting Social Security retirement benefits at that time, SSA will send you information during your seven-month Medicare initial enrollment period, which begins three months before you turn 65 years old, includes your birth month and extends three months after that.

If you haven’t signed up to collect Social Security retirement benefits by age 65, you’ll need to apply for Medicare Part A and Part B on your own. If you fail to enroll in Part B during your seven-month initial enrollment period, you may have to pay a late enrollment penalty for as long as you have Part B coverage. You may also be forced to wait to enroll, which can delay your coverage.

You can sign up for Medicare online through the SSA website. Still working? You might be able to delay Medicare enrollment if you’re covered under a qualified group health plan through your employer or your spouse’s employer.

After you enroll in Medicare, SSA will send you a Welcome to Medicare booklet along with a red, white and blue Medicare membership card. If your card is lost or stolen, you’ll need to request a replacement card online from SSA by creating your personal my Social Security account or by calling 1-800-772-1213.

Once you’re enrolled, all your Medicare services and benefits will be handled by CMS — or a private health insurance company if you’re enrolled in a Medicare Advantage or a Part D plan.

Social Security collects most people’s Medicare premiums

Most people don’t get a bill from Medicare for their health coverage. Instead, their Part B premiums are automatically deducted from their monthly Social Security benefit. This happens for all beneficiaries who are enrolled in Social Security and Medicare Part B at the same time.

In 2024, the standard Part B premium is $174.70 a month. Medicare Part A has no monthly cost so long as either you or your spouse worked and paid Medicare taxes for at least 10 years.

If you’re enrolled in Part B but haven’t signed up for Social Security yet — maybe you’re waiting until age 70 to maximize your Social Security benefits — you’ll be billed quarterly by Medicare. If you don’t qualify for premium-free Part A, you’ll be billed monthly.

You can pay your bill online by logging into your Medicare account. You’ll be able to pay by credit card, debit card, or from your checking or savings account. You can learn about other payment options on the Medicare website.

If you receive coverage through a private Medicare Advantage or Part D drug plan, you get to choose whether to pay the insurance company directly or elect to have your premiums deducted from your Social Security check.

Frequently asked questions (FAQ)

  • No, early retirees cannot begin their Medicare coverage prior to their seven-month initial enrollment period around their 65th birthday. Medicare is only available to younger people under the age of 65 if they have been collecting Social Security Disability Income (SSDI) for at least two years or have been diagnosed with End-Stage Renal Disease.
  • Medicare was born out of the Social Security Administration. The federal health insurance program was established as part of the Social Security Amendments of 1965, and the SSA oversaw the Medicare program for many years. In 1977, the Health Care Financing Administration was established to administer the Medicare and Medicaid programs, though SSA remained closely connected to Medicare.

    In 2001, the Health Care Financing Administration was renamed to the Centers for Medicare & Medicaid Services (CMS).  However, some functions — like enrollment and premium collection — remained with the SSA due to its massive existing infrastructure of handling enrollment for Social Security recipients.
  • The Centers for Medicare & Medicaid Services (CMS) oversees the administration of Medicare at the national level. CMS is also responsible for administering the State Children’s Health Insurance Program (SCHIP) and several other health-related programs. CMS is part of the Department of Health and Human Services. However, the Social Security Administration (SSA) assists CMS with Medicare enrollment and premium collection.
  • Not if you begin collecting Social Security prior to age 65. You only become eligible for Medicare starting three months prior to your 65th birthday. Social Security and Medicare don’t always begin at the same time. For example, you can enroll in Medicare at age 65, and wait to start collecting Social Security until you’re older.

Bottom line

Medicare and Social Security, though distinct federal programs, both help serve older and disabled Americans. The collaboration between SSA and CMS ensures a smoother Medicare enrollment and premium collection process. Through this partnership, both programs provide essential support and security to millions of Americans. By understanding the relationship between Social Security and Medicare, you can navigate benefits, enrollment and services more effectively and make more informed decisions.