Medicare is a government national health insurance program in the United States for people 65 or older that kicked off in 1965 under the Social Security Administration. So, it stands to reason that if you’ve already started receiving Social Security benefits, you might assume that Medicare benefits come automatically.
Not so fast.
It’s important to understand that Medicare and Social Security are separate programs. Today’s Medicare is still a federal health insurance program that provides coverage for people over 65, but it also covers younger people living with disabilities. Social Security, on the other hand, is a program that offers financial assistance to retired workers and disabled workers and their families.
And while Medicare was initially tied directly to Social Security, it’s now administered by the Centers for Medicare and Medicaid Services.
Social Security sign-up with Medicare
It’s important to note that if you’re receiving Social Security benefits, you’ll automatically be enrolled in Medicare Part A and Part B when you become eligible. However, if you’re not receiving Social Security benefits, you’ll need to sign up for Medicare on your own.
So, the answer is “sometimes.” Whether or not you automatically get Medicare with Social Security depends on your age and the reason you’re receiving Social Security benefits. Here are four common scenarios:
- If you’re over 65 and receiving Social Security retirement benefits, you’ll automatically be enrolled in Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) when you become eligible.
- If you’re under the age of 65 and receiving Social Security disability benefits, you’ll automatically be enrolled in Medicare Part A and Part B after you have received disability benefits for 24 months.
- If you get Social Security benefits based on the work record of a family member — like a spouse or a parent — you’ll need to sign up for Medicare on your own, but you have to wait until just before your 65th birthday. We’ll go into depth on enrollment below.
- If you’re over 65 but not receiving Social Security benefits, you can still sign up for Medicare.
What if I’m under 65?
Remember, just because you get Social Security benefits doesn’t mean you’re eligible for Medicare. Even though you can start collecting Social Security retirement benefits at age 62, most aren’t eligible for Medicare until they turn 65. Many individuals may have Social Security without Medicare for several years.
If I’m not enrolled in Medicare automatically, when can I enroll?
Let’s say you’re not in a category that is not automatically enrolled in Medicare, but you want Medicare coverage. You need to determine the Initial Enrollment Period.
Each Medicare beneficiary’s Initial Enrollment Period is unique because it all depends on your 65th birthday. You can initially enroll in Medicare during the seven-month window that begins three months before the month in which you turn 65. So, for example, if you turn 65 on July 4th, your Initial Enrollment Period starts on April 1st and ends on October 31st, for a total window of seven months.
Can I still enroll in Medicare if I miss the Initial Enrollment Period?
Suppose you miss your unique Initial Enrollment deadline. In that case, you’ll have to wait for the General Enrollment Period to enroll in Medicare Part A and Part B. General Enrollment runs from January 1st to March 31st each year. When you apply for Medicare during the GEP, your benefits will begin the first of the month after you apply.
What happens if I miss the Medicare General Enrollment Period?
The dates and deadlines outlined above are super important to remember because, unless you have similar health and medical coverage — like from an employer — because if you wait too long, you may have to pay a late enrollment penalty in the form of a higher monthly premium. And it’s not a one-time late fee; the penalty premium is changed for as long as you have coverage (usually for your lifetime).
Get help with Medicare enrollment.
For those who aren’t automatically enrolled in Medicare when you start receiving Social Security benefits, navigating the Medicare signup period — and the potential penalties if you miss the deadline — can be confusing.
Need help? Our Baldwin Group Medicare team can help you with enrollment and answer your questions about Medicare coverage.
Contact us todayThis document is intended for general information purposes only and should not be construed as advice or opinions on any specific facts or circumstances. The content of this document is made available on an “as is” basis, without warranty of any kind. The Baldwin Insurance Group Holdings, LLC (“The Baldwin Group”), its affiliates, and subsidiaries do not guarantee that this information is, or can be relied on for, compliance with any law or regulation, assurance against preventable losses, or freedom from legal liability. This publication is not intended to be legal, underwriting, or any other type of professional advice. The Baldwin Group does not guarantee any particular outcome and makes no commitment to update any information herein or remove any items that are no longer accurate or complete. Furthermore, The Baldwin Group does not assume any liability to any person or organization for loss or damage caused by or resulting from any reliance placed on that content. Persons requiring advice should always consult an independent adviser.
