If you receive Social Security benefits, you’ll be automatically enrolled in Medicare once you’re eligible. Medicare premiums can be deducted from your Social Security benefit payment.
Social Security and Medicare are federal programs for Americans who are no longer working. Both programs help people who have reached retirement age or have a chronic disability.
Social Security provides financial support through monthly payments, while Medicare provides health insurance. The qualifications for both programs are similar. If you receive Social Security benefits, you may be automatically enrolled in Medicare once you’re eligible.
If you’re already receiving Social Security retirement or SSDI benefits, you will be automatically enrolled in Medicare once eligible. For example, if you took retirement benefits starting at age 62, you’ll be enrolled in Medicare three months before your 65th birthday. You’ll also be automatically enrolled once you receive Social Security Disability Insurance (SSDI) for 24 months.
You’ll need to enroll in Medicare if you turn 65 but haven’t taken your Social Security benefits yet. The Social Security Administration (SSA) and Medicare will send you a “Welcome to Medicare” packet when you’re eligible to enroll. The packet will walk you through your Medicare choices and help you enroll.
SSA will also determine the amount you need to pay for Medicare coverage. You won’t pay premiums for Part A unless you don’t meet the coverage rules discussed above, but most people will pay a premium for Part B.
In 2024, the standard premium amount is $174.70. This amount will be higher if you have a large income. Social Security uses your tax records to determine the rates you need to pay.
If you make more than $103,000 a year and file an individual tax return or more than $206,000 filing jointly, SSA will send you an Income-Related Monthly Adjustment Amount (IRMAA). Your IRMAA notification will tell you the amount above the standard premium you must pay. You’ll also be responsible for an IRMAA if you buy a separate Part D plan and make over that amount.
Social Security does not pay for Medicare, but if you receive Social Security payments, your Part B premiums can be deducted from your check. This means that instead of $1,500, you’ll receive $1,325.30, and your Part B premium will be paid.
Now, let’s look at Medicare and Social Security to understand these important benefit programs, how you qualify, and what they mean for you.
Medicare is a health insurance plan provided by the federal government. The program is managed by the Centers for Medicare & Medicaid Services (CMS), a department of the United States Department of Health and Human Services. Coverage is available to Americans around their 65th birthday or who have a chronic disability.
Unlike many traditional healthcare plans, Medicare coverage is available in different parts:
- Medicare Part A (hospital insurance): Part A covers services such as hospital stays, long-term care stays, and hospice care.
- Medicare Part B (medical insurance): Part B coverage includes doctor visits, preventive care, and medical supplies.
Together, Medicare parts A and B are referred to as Original Medicare. You can get additional coverage with:
- Medicare Part C: Part C is also known as Medicare Advantage. Part C plans are sold by private insurance companies who contract with Medicare to provide coverage. Generally, Advantage plans offer all the coverage of original Medicare and extras such as dental and vision services.
- Medicare Part D: Part D plans offer coverage for prescription drugs.
You can purchase Advantage plans called Medicare Advantage Prescription Drug (MAPD) plans that include Part D coverage, or you can purchase Part D coverage separately. You can look for plans in your area using the Medicare website plan finder.
Who is eligible for Medicare?
Most people enroll in Medicare when they turn 65. You can enroll as early as three months before your 65th birthday or as late as three months after. You must be a United States citizen or have been a permanent legal resident for at least five years. You or your spouse must meet a work requirement to get full coverage. Meeting the work requirement verifies that you’ve paid into the system.
Work quarters
To meet the work requirement, you or your spouse must have worked for 40 quarters, or approximately 10 years, paying Medicare taxes.
You can still be eligible for Medicare even if you haven’t worked for 40 quarters. This simply allows you to get Part A coverage without a premium.
You can still buy Part A coverage and pay a monthly premium. If you have fewer than 30 work credits, you’ll pay the maximum Part A 2024 premium of $505. If you’ve earned between 30 and 39 credits, you’ll pay $278.
Waiting period
You can also qualify for full Medicare coverage if you have a chronic disability. You’ll need to qualify for Social Security disability benefits and have been receiving them for two years.
You’ll be automatically enrolled in Medicare after you’ve received 24 months of benefits. If you have end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS), you’ll be enrolled in Medicare without the two-year waiting period.
Social Security is a program managed by the Social Security Administration (SSA) that pays benefits to Americans who have retired or who have a disability. You pay into Social Security when you work. Money is deducted from your paycheck each pay period.
You receive Social Security benefits if you can no longer work due to disability or once you’ve reached a qualifying age and stopped working. You receive your benefits in the form of a monthly check or bank deposit. The amount you’re eligible for depends on how much you’ve earned while working.
You can apply for Social Security benefits if one of these situations apply to you:
- You’re 62 or older.
- You have a chronic disability.
- Your spouse who was working or receiving Social Security benefits has died.
Social Security retirement benefits are designed to replace a portion of the monthly income you earned before you retired.
Who is eligible for Social Security retirement benefits?
To be eligible for Social Security retirement benefits, you must meet a few requirements. Like with Medicare, you must be a United States citizen or permanent resident. You might also need to have worked and earned credits. The amount of credits you need depends on your circumstances and the type of benefit you’re applying for.
To apply for retirement benefits, you’ll need at least 40 credits. Since you can earn up to four credits a year, you’ll earn 40 credits after 10 years of work. This rule applies to anyone born after 1929.
The amount you’ll receive per month will depend on your income throughout your working life. The Social Security website has a calculator you can use to estimate your retirement benefits.
Spouses and Social Security retirement benefits
Your spouse can also claim up to 50% of your benefit amount if they don’t have enough work credits or if you’re the higher earner. This doesn’t take away from your benefit amount. For example, say you have a retirement benefit amount of $1,500, and your spouse has never worked. You can receive your monthly $1,500, and your spouse can receive up to $750. This means your household will get $2,250 each month.
How the age you retire affects your benefits
You can apply for Social Security retirement benefits once you’ve turned 62. However, you’ll receive more money per month if you wait a few years. People who start collecting retirement benefits at 62 receive 70% of their full benefit amount. You can receive 100% of your benefit amount if you don’t start collecting until full retirement age.
The full retirement age for people born after 1960 is 67. If you were born before 1960, refer to this chart from Social Security to see when you’ll reach full retirement age.
If you have a limited income, you can qualify for additional benefits. These benefits, known as Supplemental Security Income (SSI), are for people with limited incomes who qualify for Social Security because of age or disability.
Who is eligible for SSI?
You can qualify for SSI if you:
- are over 65
- are legally blind
- have a disability
As with all Social Security benefits, you must also be a United States citizen or legal resident and have limited income and resources. However, you don’t need work credits to apply for SSI.
You can receive SSI in addition to SSDI or retirement benefits or as a stand-alone payment. The amount you receive in SSI depends on your income from other sources.
Social Security Disability Insurance is a type of Social Security benefit for those with disabilities or health conditions that prevent them from working.
Who is eligible for SSDI?
The rules for applying for SSDI are different. If you’re applying at age 62 or older, you’ll need 40 work credits.
To qualify for SSDI, you must:
- be unable to work because of a medical condition that will last at least 12 months or is terminal
- not currently have a partial or short-term disability
- meet SSA’s definition of a disability
- be younger than full retirement age
You must prove you meet these criteria, and this process can be difficult. Once you qualify for SSDI, the amount of disability income you’ll receive may be based on your age and the amount of time you’ve worked and paid into Social Security.
This table explains what benefits are offered based on your age and number of years worked:
Application age and SSDI benefits
| Age you apply: | Amount of work you need: |
| Before 24 | 1 ½ years of work in the past 3 years |
| Ages 24 to 30 | Half the time between 21 and the time of your disability. For example, you’ll need 3 years of work to qualify if you become disabled at 27. |
| Ages 31 to 40 | 5 years (20 credits) of work within the decade before your disability |
| 44 | 5 ½ years (22 credits) of work within the decade before your disability |
| 46 | 6 years (24 credits) of work within the decade before your disability |
| 48 | 6 ½ years (26 credits) of work within the decade before your disability |
| 50 | 7 years (28 credits) of work within the decade before your disability |
| 52 | 7 ½ years (30 credits) of work within the decade before your disability |
| 54 | 8 years (32 credits) of work within the decade before your disability |
| 56 | 8 ½ years (34 credits) of work within the decade before your disability |
| 58 | 9 years (36 credits) of work within the decade before your disability |
| 60 | 9 ½ years (38 credits) of work within the decade before your disability |
You can claim survivor benefits if your deceased spouse earned at least 40 credits. You can also claim benefits if your spouse died young but worked for 1 ½ of the 3 required years before their death.
Who is eligible for survivor benefits?
Surviving spouses are eligible for benefits:
- at any age if they are caring for children under 16 or who have a disability
- at 50 if they have a disability
- at 60 for partial benefits
- at full retirement age for 100% of the benefit amount
Benefits can also be paid to:
- ex-spouses
- children up to 19 who are still attending high school
- children with a disability that was diagnosed before 22
- parents
- stepchildren
- grandchildren
Additionally, a surviving spouse and their child can both receive benefits. Combined benefits can equal up to 180% of the original benefit amount.
Social Security and Medicare help Americans who are not working due to age or disability. You don’t have to receive Social Security benefits to qualify for Medicare.
If you receive Social Security benefits, you will be automatically enrolled in Medicare once you become eligible. Your Medicare premiums can be deducted straight from your benefit payment.
Regardless of your age, you can start researching now to see how Social Security and Medicare together can be part of your retirement planning.