Medicare vs. Social Security: Clearing Up the Confusion

Confused about Medicare & Social Security

Professional Confusion

Just last week, a client informed me he was warned by a “professional” at the local social security office that he could not receive Medicare benefits without first drawing social security. My immediate response was shock—that someone working in the social security administration did not understand Medicare any better than that, and, worse, would dispense patently false information to people depending on his “expertise.” But that illustrates the type of confusion that exists regarding the relationship between Medicare and social security. Well, it’s time to eliminate the misunderstanding.

The Connection between Medicare & Social Security

So, what is the relationship between the two? The correlation concerns whether one qualifies for getting Medicare Part A for a zero premium or has to pay a premium to get it.

An individual becomes eligible for Part A at no cost if he or she is entitled to receive Social Security benefits or railroad retirement benefits, or if that person’s spouse (living or deceased, including divorced spouses) is eligible to receive Social Security or railroad retirement benefits (or if the individual is the dependent parent of a fully insured [under the Social Security program] deceased child). To simplify, if one works ten years (or 40 quarters) in jobs that deduct social security taxes, he or she qualifies for premium-free Medicare Part A.

Can I Get Medicare Part A?

But what if you have not met that qualification; can you still get Medicare Part A? The answer is yes. You may qualify for premium-free Part A based on the work record of your spouse. (In that case, your spouse—either your current, deceased, or even divorced spouse—needs to have met the 40-quarter qualification and needs to be at least 62 years of age.)

Otherwise, if you’re 65 or older, you can buy into Medicare by paying monthly premiums for Part A hospital insurance. This premium can cost up to $411 per month, depending on the amount of qualified quarters you worked. (By acquiring Part A, you can also get Part B by paying the same premiums as other people.)

Don’t Fall for the Wrong Information

Now we return to the government worker’s false statement: You can’t get Medicare without, first, drawing social security. Many of my clients get Medicare at age 65 but delay their social security benefits until 66 or later. (A very small minority of them wait until 70.) So, yes, you can benefit from Medicare coverage long before drawing social security. The key here is: If you qualify to receive social security benefits—no matter when you choose to draw social security—you will also qualify to receive Medicare Part A at a zero premium. If you are in that category, congratulations! But don’t fall for someone telling you that you have to draw your social security before you can get on Medicare; that simply is not true.


Recommended Posts