How Are Social Security And Medicare Related
Medicare and Social Security offer different types of benefits, so how are they related? Medicare enrollment is actually processed by the Social Security Administration, or SSA.
Although the Centers for Medicare & Medicaid Services oversees the Medicare program, they do not handle Medicare enrollment. Instead, CMS is in charge of various features of Medicare, such as the structure of Medicare benefits and overseeing insurance companies that provide Medicare plans.
In addition to handling enrollment, the Social Security Administration also processes Medicare payments. Many people who qualify choose to have their Medicare Part B premiums taken directly out of their Social Security benefit checks rather than paying them online or using another method.
In general, the way to think of these programs is that CMS decides what healthcare benefits Medicare beneficiaries receive as well as how much everything costs. The Social Security Administration processes Medicare applications and payments. SSA also administers the benefits and tracks eligibility of the relevant population.
If you want to know whats going on with Medicare, you go to CMS, but if you have questions about your specific enrollment, you go to the SSA.
Medicare Supplement Plan Eligibility
Like Medicare Advantage, Medicare supplemental insurance often called Medigap because it fills in the out-of-pocket coverage gaps in Medicare Parts A and B is also purchased from private insurers.
Medigap helps cover copayments, coinsurance and deductibles from Medicare Part A and Part B.
You must meet one of these qualifications to be eligible for Medigap coverage:
- You must be 65 or older.
- You have been diagnosed with Lou Gehrigs disease.
- You have been entitled to Social Security or U.S. Railroad Retirement Board disability payments for at least 24 months.
- You have been diagnosed with end-stage renal disease, requiring regular dialysis or a kidney transplant.
When To Start Your Social Security
Here in America, you are eligible to begin taking Social Security benefits as early as age 62. However, that is if you have earned enough credits. The latest that you can start your benefits is at age 70.
If you begin your Social Security benefits at age 62, your benefits will be reduced based on the number of months that you receive your benefits before you have reached your full retirement age.
Your full retirement age in terms of Social Security is generally at age 66 and a half. However, this varies based on the year that you were born. Visit this page on the Social Security website for more specifics.
In very simple terms, taking income benefits earlier than your full retirement ages means your benefit amount will be lower. Waiting and taking those benefits later, up to age 70, means you will have a larger monthly benefit check.
Delaying your Social Security income benefits does not affect your eligibility for Medicare at age 65 either.
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Who Is Eligible For Medicare Advantage Plans
Youll automatically qualify for Medicare Advantage once you qualify for Part A and Part B coverage. Advantage plans are sold by private companies and are designed to cover some of the out-of-pocket costs Original Medicare does not cover.
4 Medicare Advantage Eligibility Requirements
While regular Medicare Advantage does not cover ESRD, you may qualify for a Medicare Special Needs Plan . SNPs are special types of Advantage plans specifically designed for a particular condition or financial situation.
You can keep your Medicare Advantage plan if you purchased it before developing ESRD. You can also buy an Advantage plan after being medically determined to no longer have ESRD usually from a successful kidney transplant.
Don’t Leave Your Health to Chance
Do Part D Drug Plans Come Out Of My Check
You can have your Medicare Part D premiums deducted from your Social Security check if you wish. When you enroll in your drug plan, the system will give you the option.
Be aware that if Medicare Allies is helping you with your drug plan enrollment, youâll need to let us know if you want that to happen. You may need to pay your premium directly for a couple of months before your request goes into effect.
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Understanding Social Security And Medicare
Social Security and Medicare are both federal programs. Together, these programs help those no longer working due to retirement or disability. There are similarities and differences between these two programs. In some ways they work together and yet, they are two separate programs. Just because you qualify for one doesnt mean youll immediately qualify for the other.
People Enrolled In Both Social Security And Medicare Have Their Premiums Automatically Deducted From Their Monthly Check
If you receive Medicare health insurance benefits and Social Security retirement benefits at the same time, you can have your Medicare premiums automatically deducted from your Social Security check each month. This can save a lot of time and energy, as you wont have to worry about paying your premiums manually. This option is available for every part of Medicare, including private plans like Medicare Advantage and Medicare Part D.
This article explains everything you need to know to understand how much will be deducted from your Social Security benefits.
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Analyze Medicare Premiums With A Licensed Agent
Deductibles, coinsurance and other out-of-pocket costs may not always be predictable expenses, but premiums will be there month after month.
When analyzing the cost of premiums for various parts of Medicare and plans associated with Medicare, consider what that premium affords you in terms of coverage and additional costs.
A licensed insurance agent can help you examine the 2021 premium costs of your Medicare options as you find a health insurance plan that suits your budget.
Reaching Age 62 Can Affect Your Spouse’s Medicare Premiums
Although reaching age 62 does not qualify you for Medicare, it can carry some significance for your spouse if they receive Medicare benefits.
When one spouse in a couple turns 62 years old, the other spouse who is at least 65 years old may now qualify for premium-free Medicare Part A if they havent yet qualified based on their own work history.
- For example, Gerald is 65 years old, but he doesnt qualify for premium-free Part A because he did not work the minimum number of years required for eligibility. He can still receive Medicare Part A, but he will have to pay a monthly premium for it. In 2020, the Medicare Part A premium can be as high as $458 per month.
- Lets say Geralds wife, Jessica, reaches age 62 and has worked for the required number of years to qualify for premium-free Part A once she turns 65. Because Jessica is now 62 years old and has met the working requirement, Gerald may now receive premium-free Part A.
In the above example, Jessica has not become eligible for Medicare by turning 62. Her husband Gerald, however, is now eligible to receive his Medicare Part A benefits without paying a monthly premium any longer.
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Age 70 Is When Your Potential Retirement Benefits Reach Their Maximum
Though 62 remains the most popular age to start collecting Social Security, there are plenty of filers who opt to take their benefits later. Some choose to wait until full retirement age in order to avoid a reduction in payments. Others might opt to wait even longer and accrue delayed retirement credits in the process. But there comes a point where it no longer pays to hold off on filing for benefits — specifically, age 70. Though you’re not compelled to sign up for Social Security at that time, delaying will only cause you to lose money — money you’re entitled to.
Find A $0 Premium Medicare Advantage Plan Today
For California residents, CA-Do Not Sell My Personal Info, .
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.
The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with TZ Insurance Solutions LLC, TruBridge, Inc. and/or a third-party partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier. TZ Insurance Solutions LLC, TruBridge, Inc., and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.
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Special Enrollment Periods For Medicare
Medicare special enrollment periods can happen any time during the year due to changes to your personal circumstances.
Examples of Medicare Special Enrollment Qualifying Events
- Moving somewhere outside of the coverage area of your current Medicare Advantage plan
- Phasing out of your employers health insurance plan
- Your current Medicare Advantage provider ending its contract with Medicare
The Benefits Of Lowering The Age Of Eligibility For Medicare
From 10,000 feet up, the idea of lowering the age is good news for some. Ive had clients who were able to save large sums and could financially afford to retire but felt like they had to keep working until they could get guaranteed health coverage at age 65 through Medicare.
And then there are those who are forced into early retirement. If you lose your job and are over 55, finding a new job isnt always easy. So what do you do for healthcare at that point?
The plans you can buy on the healthcare exchange plans are very expensive for older Americans. This is where access to Medicare at 62 or even younger ages could help.
According to one study, a typical 60-year-old could buy into Medicare for about $8,000 less per year as compared to a gold-level plan on the insurance exchanges, and $3,700 less than buying a bronze-level plan.
A 2019 Kaiser Family Foundation poll also found most Americans support expanding Medicare coverage. 77% of respondents support the idea of introducing a Medicare buy-in for people as young as 50. This support seems bipartisan 85% of Democrats and 69% of Republicans polled approved of the idea.
At face value, it seems that lowering the eligibility age could be the perfect solution that provides the most options for individuals who are nearing retirement age.
But despite the broad idea of this proposal having public support, there are a few roadblocks that any of these proposals to lower the age will likely meet.
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Who Pays The Premium For Medicare Advantage Plans
You continue to pay premiums for your Medicare Part B benefits when you enroll in a Medicare Advantage plan . Medicare decides the Part B premium rate. The standard 2021 Part B premium is $148.50, but it can be higher depending on your income. On average, those who received Social Security benefits will pay a lesser premium rate.
Usually, you pay a separate monthly premium for a Medicare Part C plan. But not all Part C plans have monthly premiums. In addition to covering medically necessary procedures, Part C plans typically provide prescription drug coverage and other types of benefits such as dental and vision. The premium you may pay is used to cover the wider range of services available with Medicare Part C.
The Medicare-approved private insurance companies that offer Medicare Part C coverage decide what services the plans will cover, so monthly premiums vary from plan to plan and state to state. Insurance companies are only allowed to make changes to the premium rate once a year.
Can You Get Medicare At Age 60
You cant enroll in Medicare before age 65 unless you have a permanent disability. If youre under age 65 and have a disability, youll automatically get Part A and Part B after 24 months of Social Security Disability Insurance or RRB disability benefits.
The rules are more generous if you have permanent kidney failure or ALS. With either of these disabilities, you can qualify for Medicare right away without the typical 2-year SSDI waiting period. If you have ESRD, you have the option of joining a Medicare Advantage plan if you want, and any Part B late penalties are often waived.
Some leaders and lawmakers previously have proposed lowering the Medicare eligibility age for the general population, but that hasnt come to pass. In his 2022 budget, President Joe Biden proposed giving people age 60 and older the option to enroll in Medicare. In 2021, more than 150 House Democrats suggested lowering the Medicare age to 60 or 55. A bill introduced to Congress in April 2021 aimed to give certain qualified individuals between the ages of 50 and 64 the option to enroll in Medicare.
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To Qualify For Medicare You Need To Get Disability Benefits From:
- Social Security
- Railroad Retirement Board
If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.
If you live in Puerto Rico or outside the U.S.
Is Medicare Mandatory If You’re On Disability
Social Security will start to automatically enroll most SSDI recipients in both Medicare Parts A and B before their 25th month of SSDI benefits. Three months before your coverage starts, the SSA will send you your new Medicare card, with your name, your Medicare number, and the dates your Part A and Part B coverage will start. The SSA will automatically deduct your monthly premiums from your Social Security check at the start of your 25th month of benefits unless you send back your Medicare card . Then your coverage begins.
For practical purposes, you can’t decline Medicare Part A, which covers hospitalization and skilled nursing stays. So Medicare Part A is mandatory if you’re on disability, but Social Security doesn’t usually take any money out for Part A premiums anyway.
You can decline Medicare Part B, which covers doctors’ visits, x-rays, lab fees, surgery, and the like. Social Security will take money out of your SSDI check for Part B premiums, so people who are covered under their spouse’s employer-based health care insurance sometimes want to decline it .
If you don’t want Part B, send the card back to Medicare . If you keep the card, you will have Part B coverage and Social Security will take the Part B premium out of your SSDI benefits.
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How Soon Can I Take Social Security
When it comes to receiving the maximum Social Security benefit possible, timing is important. Sometimes beneficiaries may receive more by delaying withdrawal, but some older adults may need the funds sooner.
Start by asking yourself some questions:
- Do I want to retire early?
- Do I want to/need to work past age 70?
- What happens to my Medicare if I work past age 65?
The SSA website offers future planning calculators, opens new window to help you estimate things that can affect retirement. These include life expectancy, pension eligibility, spousal benefits and retirement age.2
While you can take benefits as early as age 62, it may not be recommended. Only those on disability, or surviving spouses, can take Social Security earlier than 62.3
Your full retirement age, also known as normal retirement age, determines if you can receive full benefits. While the original full retirement age was 65 for all, heres a snapshot of how the law has changed:
If you take Social Security up to 36 months before your full retirement age, your benefit will be permanently reduced by 5/9 of 1%. If you withdraw more than 36 months early, your benefit is reduced by 5/12 of 1% each month.4
Act Quickly If You Want A Medicare Advantage Or Part D Plan When You Retire
When you work past 65 and qualify for a Special Enrollment Period, there is one tricky thing to note about this time period. The Special Enrollment Period lasts 8 months, but you only get the first two months to enroll in a Medicare Advantage or Part D plan.
Many people get tripped up by this because they do get the full 8 months to get Part A and Part B. And this is even trickier when you consider that you need both Parts A and B to get a Medicare Advantage plan, and either Part A or Part B to get a Part D stand-alone plan.
TIP: Enroll in everything you want and need within the first two months of your Special Enrollment Period to ensure you dont accidently get hit with financial penalties for Part D.
Another good reason to enroll in the first two months is that it can take some time for plans to process your application. Make your decisions and enroll early to avoid a lapse in coverage.
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