Do You Automatically Get Medicare with Social Security?

Do You Get Medicare with Social Security Automatically?

Most people who collect Social Security benefits automatically receive Original Medicare (Parts A and B) coverage once they're eligible. 

Medicare and Social Security are two benefits programs managed by the United States government. Medicare currently has over 61 million beneficiaries. 

Both federal initiatives are linked, meaning that many individuals receiving Social Security payments may automatically receive Medicare benefits once they qualify for Medicare based on age or disability.

In this article we review how people can receive Medicare health insurance coverage alongside their Social Security benefits. 

How Does Automatic Enrolling in Medicare Work?

If you receive benefits through the Railroad Retirement Board (RRB), you’ll receive the same Medicare coverage. 

So, when do you have to sign up for Medicare?

You’ll become eligible to apply for Medicare when one of the following events occur:

• You turn 65 (automatic enrollment in Part A and B occurs three months before your 65th birthday if you’re already receiving Social Security retirement benefits)
• You have end-stage renal disease (ESRD)
• You have Lou Gehrig's Disease, amyotrophic lateral sclerosis (ALS)
• You have been on Social Security disability insurance for 24 months and have a qualifying condition. These include heart and lung issues, neurological disorders, cancer, kidney dysfunction and other severe health problems.

If you live in Puerto Rico and receive Social Security or RRB benefits, you’ll only become automatically enrolled in Medicare Part A. If you want Medicare Part B, you'll have to apply for Medicare benefits to kick in. 

Those receiving Social Security benefits who also qualify for both Medicare and Medicaid will also be awarded Medicare Part D prescription drug coverage automatically. If you don't qualify for Medicare and Medicaid, you'll need to compare Part D prescription drug plans or Medicare Advantage (Medicare Part C) plans that include Part D coverage and enroll in a plan available where you live.

Once you’re registered, you’ll receive an enrollment notice and your Medicare card. Most people don’t pay premiums for Medicare Part A. If you’re automatically enrolled in Medicare Part B, you’ll be required to pay a monthly Part B premium. The standard Part B premium in 2023 is $164.90 per month.

Your Part B premiums can be deducted out of your Social Security check, but there are other ways to pay. You can opt to cancel Part B through the Centers for Medicare & Medicaid Services (CMS), though it’s not advised unless you have qualified health insurance through another provider, such as through an employer or union.

Can You Get Social Security and Not Sign Up for Medicare?

Yes, many people receive Social Security without signing up for Medicare. 

Most people aren’t eligible for Medicare until they turn 65. As you can start collecting Social Security retirement benefits at 62, individuals may have Social Security without Medicare for several years.  

So, when do you need to sign up for Medicare? Most people enroll in Part B once they turn 65, but you may decide to delay enrolling in Part B if you or your spouse has health insurance through an employer. Be sure to learn more about how Medicare enrollment works in your specific case, though. If you delay enrollment in Medicare Part B when you’re first eligible and you don’t have other creditable coverage, you could face late enrollment penalties for the rest of the time that you have Part B once you sign up for Medicare.

As most people don’t pay a premium for Part A, there’s no reason to cancel the coverage, even if you don’t think you need it. You are free to decline other Medicare plans, such as Parts B and D, though again you should make sure you won’t cause yourself to go without coverage or have to pay late enrollment penalties in the future.

What Insurance Do You Get with Social Security Disability?

In most cases, people receiving Social Security Disability Income (SSDI) are automatically enrolled in Original Medicare after serving a 24-month waiting period. 

The CMS waives this waiting period for people with ALS or end-stage renal disease. People with these conditions receive Medicare coverage as soon as they collect SSDI. 

Is It Mandatory to Sign Up for Medicare After Age 65?

No, it isn’t mandatory to join Medicare. People can opt to sign up, or not.

If you don't qualify for Social Security retirement benefits yet, you may need to manually enroll in Medicare at your local Social Security office, online or over the phone when you turn 65. You can also apply online for your Medicare coverage at www.medicare.gov.

Enrolling in Medicare as soon as you’re eligible ensures you get the subsidized health care you deserve without waiting periods or financial penalties.

If you continue to work for a company employing 20 or more people after you turn 65, you could delay your Medicare enrollment. Your employee group plan provides enough medical coverage while you’re working, meaning you may be able to wait to sign up for Medicare once you retire without incurring any late penalties.

What Happens If You Don’t Sign Up for Medicare?

It’s always your choice whether you sign up for Medicare, but you should understand the consequences of not signing up for this health insurance, including:

• You’ll pay the full amount for all medical care unless you have private health insurance
• You may face delays getting Medicare coverage in future
• You’ll face penalties if you change your mind and sign up for Medicare later

Automatic enrollment for Social Security beneficiaries makes getting Medicare easy. While you always have a choice about which Medicare plans you keep, consider their benefits now and in the future before making any decisions about your insurance-based coverage.