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How Do Social Security and Medicare Work Together?

"How do Social Security and Medicare Work Together?" Over image of Social Security card and money with calculator

Just the Essentials…

  • The Social Security Administration determines eligibility for Social Security benefits.

  • The Social Security Administration also determines which individuals qualify for Medicare.

  • Medicare costs can be deducted automatically from Social Security benefits.

  • Benefits for both federal programs are funded by payroll taxes.

Are Social Security and Medicare the same?

Many Americans tend to see both Social Security and Medicare as the same program. In reality, they are not. Instead, they are different programs which share many similarities and work together to provide Americans who are at retirement age or older with many crucial benefits.

Though the Social Security Administration and Centers for Medicare and Medicaid Services (CMS) are separate branches, the Social Security Administration is in charge of determining eligibility for both programs. The eligibility criteria for both programs is similar in many ways, but there are a few key differences.

Let’s take a look at some of the criteria you’ll need to meet in order to qualify for Social Security, as well as qualify for Medicare eligibility.

How do I know if I'm eligible for either Social Security or Medicare benefits?

You may sign up to receive Medicare Part A benefits at zero cost if:

  • You are three months from your 65th birthday or older.
  • You are a current recipient of, or eligible to receive, Social Security benefits.
  • You are a current recipient of, or eligible to receive, benefits from the Railroad Retirement Board (RRB).
  • Your spouse – living, deceased, or divorced – receives, or is eligible to receive, Social Security or RRB benefits.
  • You, or your spouse, worked a specific period of time in a government position through which Medicare taxes were paid.
  • You are the dependent parent of a fully insured deceased child.

To be eligible for and receive Social Security benefits, you must:

  • Have earned enough credits* while employed (minimum number of 40 for most workers).
  • Be between the ages of 62 and 70.

*”Credits” refer to a specific amount of money earned to be credited toward your personal Social Security benefits. For example, the amount of earnings needed for one credit in 2019 was $1,360. You can earn up to four credits per year.

As seen above, signing up for and receiving Social Security benefits upon meeting the age of eligibility qualifies you to receive Medicare Part A benefits at zero cost.

If you’re in need of an affordable Medicare plan, you have options. Enter your zip code above to discover cost effective Medicare plans available in your area!

Both of These Federal Programs Are Funded by Taxpayer Dollars

Payroll taxes provide the funding base for both of these federal benefits. Unless you are self-employed, the responsibility for paying these taxes is split evenly between you and your employer. These taxes are withdrawn in unison as Federal Insurance Contributions Act, or FICA, taxes.

Lawmakers from both parties are constantly proposing reforms for Medicare and Social Security systems. However, both parties are constantly in gridlock regarding which types of reforms to implement.

The GOP currently favors three approaches to reforming both programs. These approaches include means testing, raising the full retirement age, and privatization. Meanwhile, Democrats are calling for expansion of the Social Security tax to apply to all incomes. It is believed that this move would boost program revenue and create program stability without needing to reduce benefits.

Is It Possible to Receive Medicare and Social Security Before the Age of 65?

Yes and no. As mentioned above, you can apply for and receive Social Security benefits beginning at age 62, but it comes at a cost. Applying before retirement age may cause reduced Social Security benefits for individuals who are:

  • 66 years of age for individuals born between 1943 and 1954.
  • 67 years of age for individuals born in 1955 and after.

You are eligible to apply for and receive Medicare before the age of 65 at zero cost if you meet the following Medicare eligibility criteria:

  • You currently receive Social Security Disability Insurance (SSDI), or have been eligible to receive SSDI for 24 months.
  • You currently receive disability pension from the Railroad Retirement Board (RRB) and meet specific criteria.
  • You’ve worked in a government job long enough through which you’ve paid Medicare taxes and met SSDI requirements for 24 months.
  • You’re the child or widow(er) age 50 years or older of a worker who has worked long enough under Social Security or in a Medicare-covered government position and you meet SSDI requirements (applies to divorced widows or widowers as well).

While you may be eligible to receive SSDI if you have a disability and are unable to work, you cannot receive typical Social Security benefits prior to the age of 62.

Is It Possible to Enroll in Medicare Without Social Security?

One of the questions we hear most would be, “Can I enroll in Medicare without Social Security?The short answer is yes, you can enroll in Medicare without Social Security.

Enrolling in Medicare without enrolling in Social Security is a top option for those who prefer to continue working instead of going into retirement. However, be aware that if you choose to enroll in Medicare without Social Security, you’ll need to pay for your Medicare costs through a method that you set up on your own.

Paying For Medicare With Social Security Benefits

While Medicare Part A is typically available for those eligible at zero cost, others will have to pay a premium. Premiums must also be paid for Medicare Part B.

You are able to pay for Medicare premiums using five different methods. One of these methods is to have them deducted automatically from your Social Security benefits.

As of 2021, Medicare Part B premiums average $148.50 per month. Medicare costs are dependent on income, so you may have to pay more and will be notified by Medicare about adjusted premium payments.

No matter your specific situation, the licensed insurance agents at MedicareInsurance.com are happy to help you research and compare your Medicare plan options. Simply enter your zip code below, or call our Medicare Advantage experts at (800) 950-0608 today to get informed about Medicare options in your state!

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