Social Security and Medicare: How They Work Together

Have you attained retirement age and have a disability that hinders you from engaging in any significant activity? Well, both Social Security and Medicare are federal programs formulated to help Americans who no longer work. 

Did you know that as of 2019, 69.1 million people were beneficiaries of programs that the Social Security Administration (SSA) administered? And Medicare was part of these programs. Of this number, 55% of the Social Security adult recipients were women.

Social Security offers financial support that comes in monthly payments. On the other hand, Medicare is responsible for providing health insurance. The qualifications for these two programs are almost the same. In essence, getting Social Security benefits is one instant way that qualifies you to enroll in Medicare once eligible. 

If you are receiving Medicare benefits, the SSA- Social Security Administration will no doubt enroll you for Medicare parts A and B. This is once you’re 65 years old. Medicare is regulated by the Federal Centers for Medicare and Medicaid Services. 

On the other hand, the Social Security Administration, which handles enrollment, was created as an independent body. But, it’s now a government-operated body that benefits older Americans.

Thus, SSA manages both Social Security benefits and Medicare eligibility. Those who start receiving Social Security retiree benefits before 65 years will automatically get enrolled in Medicare as soon as they hit 65.

So, while Social Security and Medicare are separate programs, they are intertwined in some ways. Let’s find out the relationship between the two programs and how they work together.

How Does Social Security and Medicare Work Together?

As mentioned earlier, you’ll get Medicare without a doubt if you’re already getting Social Security Disability Insurance (SSDI) benefits. If, for instance, you took the social security retirement benefits at age 62, you’ll later get enrolled in Medicare three months before hitting your 65th birthday. 

You also get enrolled in Medicare automatically if you’ve been receiving SSDI for at least 24 months. But, you can also enroll in Medicare even when you turn 65 and haven’t yet taken your Social Security benefits. 

The SSA and Medicare often send you a ‘welcome to Medicare’ pack once you are eligible to enroll. The pack will take you through your best Medicare plans to help you register. 

So, there’s usually more flexibility in Social Security’s eligibility. You can apply to start receiving Social Security earnings as early as 62 years. 

But, the earlier you start collecting the benefits, the lower your monthly earnings. You’ll often get higher monthly income payments when you wait to claim the Social Security benefits at 70 years.

Both Medicare and Social Security benefits are available to people despite their income levels. Thus, wealthy Americans and those under the lower income categories can enjoy the benefits. This is different from Medicaid eligibility, which only favors low-income Americans.

When to Apply for a Medicare Plan?

When you’re applying for Medicare for the first time, you must consider your critical enrollment periods. Such includes the Initial Enrollment Period (IEP).

Once you miss any of the above, you may only manage to enroll during the Special Enrollment Period. And this is only possible if you qualify. 

So, if you’re operating in a state like Florida and want to enroll for Medicare in Florida, you must consider the crucial window periods. The Initial Enrollment Period (IEP) is when Floridians are deemed medicare-eligible for the first time. 

Hence, you can successfully enroll for Florida Medicare plans at this time. This window begins three months before your 65th birthday, including your birthday month, and ends three months after you turn 65. 

In this case, Your IEP for Florida Medicaid application lasts for seven months. The enrollment period is critical. By missing it, you can easily incur late enrollment penalties. 

Also, in case you miss your IEP, the next time you may be eligible to enroll for Medicare in Florida could be the General Enrollment Period (GEP).

The GEP occurs between January 1-March 31 every year. Let’s say you enroll for the best advantage Medicare plan around such time. In this case, your Medicare coverage will start on July 1. 

Social Security Administration’s Role in Medicare Enrollment and Payment

SSA will determine the amount you should pay for your Medicare coverage. You can only pay for Medicare premiums Part A when you meet the coverage rules. But, often, most people will pay for Medicare premium Part B.

Remember that the Medicare program that SSA enrolls people in consists of several parts. Medicare Part A and B form, what’s now known as Original Medicare, helps to know how Original Medicare works.

Part A is often regarded as hospital insurance. It covers some of the necessary costs at several medical and healthcare facilities. This happens whenever you’re taken in as an inpatient. 

Some people are automatically enrolled for Part A as soon as they are eligible. Again, others must sign up for the medical insurance benefit through the SSA.

Most people with Part A won’t have to pay for the premium. But, there are other costs that you may have to pay if you need hospital care. Such include the:

  • Deductibles
  • Copays
  • Coinsurance

By 2020, the standard premium amount was USD 144.60. This amount tends to be higher if you have a larger income. The Social Security Administration utilizes your tax records to establish the rates you need to pay.

For example, if you earn more than $87,000 per year, SSA will send you a Medicare IRMAA- Income-Related Monthly Adjustment Amount. Your IRMAA notification will inform you of the amount you should pay above the standard premium. 

You’ll also be liable for an IRMAA if you decide to buy a separate Part D plan and you earn anything above $87,000. That’s why it helps to know what IRMAA is and why it’s deducted from your social security.

Key Takeaways

We’ve discovered that Social Security and Medicare are organizational programs within the federal government under different management. Social Security is directed by the Social Security Administration, while Medicare is operated by the Centers for Medicare and Medicaid Services.

The SSA is responsible for determining who’s qualified for Social Security benefits and who qualifies for Medicare. Overall, SSA executes many administrative functions for Medicare.

It helps to know that Social Security doesn’t pay for Medicare. But, if you get Social Security payments, the SSA can have your Medicare Part B premiums deducted from your check. 

To qualify for Medicare, you should be at least 65 years. But, Medicare is also accessible to younger Americans with disabilities. It’s also available for those with permanent kidney failure, requiring dialysis or kidney transplant. 

Most importantly, Social Security and Medicare benefits programs are accessible to people in all categories- those in the higher income categories and those with lower earnings.

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Christophe Rude

Christophe Rude

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