Social Security and Medicare

Both the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) are federal organizations intended to provide benefits to U.S. citizens and permanent residents. Though they are closely tied together, Medicare and Social Security are managed by different organizations.

CMS provides health coverage to more than 100 million people through health programs including Medicare. The Social Security Administration works with CMS to enroll people in Medicare, while also providing retirement income to eligible individuals.

How Social Security Impacts Your Medicare Eligibility

Your eligibility for Medicare Part A, which covers care received in a hospital, depends on the same credit-earning system that determines your eligibility for Social Security benefits. If you turn 65 without having enough Social Security credits to qualify for free Medicare Part A, you may be able to buy hospital coverage by making a monthly payment. However, if you have earned 40 Social Security credits over the course of your career, the U.S. government will completely cover your monthly payment, and your hospital benefits through Medicare will be free.

You earn Social Security credits by working, gaining one credit for each $1,410 you earn in 2020, up to a maximum of 4 credits in a year. The Social Security administration annually increases amount you need to earn for each credit by a small amount, according to the national average income. If you are self-employed or in the military, you earn Social Security credits the same way and at the same rate. Investment income does not qualify as wages for the purpose of earning Social Security credits. You do not lose the credits you already have by changing jobs or becoming unemployed.

If you are disabled, you can consult the Social Security Administration's guidelines to determine how many credits you need to have earned prior to becoming disabled in order to qualify for free Medicare Part A. Note that if you qualify for Social Security Disability Insurance (SSDI), you will receive Medicare coverage.

Many people are still working when they reach age 65 and 40 Social Security credits. If you still have private health insurance through an employer or through a spouse's plan when you qualify for Medicare Part A, you may still want to enroll in Medicare part A immediately, because it can act as free supplemental health insurance. When you receive care in a hospital, Medicare will pay first. Then, your private health insurance will pay toward any balance that is left over on the bill leaving you to pay any remaining balance.

If you do not have enough Social Security credits to qualify for free Medicare Part A, you may still qualify on the basis of your spouse's eligibility.

Enrolling in Medicare and Social Security Together

To save yourself the maximum amount of money, you should strongly consider enrolling in Medicare and Social Security separately. This is because the government offers financial incentives for waiting until full retirement age before applying for Social Security. If you were born after 1943, this is later than age 65, which in most cases is the age at which you become eligible for Medicare. You can see your full retirement age in the table below.

Birth YearFull Retirement Age
1943-1954 66
1955 66 and 2 months
1956 66 and 4 months
1957 66 and 6 months
1958 66 and 8 months
1959 66 and 10 months
1960 67

If you apply for Social Security benefits before your full retirement age, you will take a penalty to your Social Security check each month. For this reason, it often makes sense to apply Medicare at age 65 and delay applying for Social Security.

While there is a penalty for filing for Social Security before your full retirement age, you can file for your reduced Social Security benefits as early as age 62. This may make sense for you if you are 62 years of age or older and are laid off, suffer a long period of health issues, or become disabled. Except in the case of certain disabilities, you will still not become eligible for Medicare until age 65.

However, if you stop working during the initial Medicare enrollment period, which is the three months on either side of your 65th birthday, it can make sense for you to enroll in Medicare and Social Security simultaneously. Additionally, simultaneous enrollment in Medicare and Social Security can be easy, as you can use a combined form.

Enrolling in Medicare without Social Security Benefits

If it makes sense for you to enroll in Medicare while delaying applying for Social Security benefits, how should you go about applying?

You can apply online for Medicare only at the Social Security Administration website.

The application is short, but you can save your application and return to it later if needed. You can also return to check the status of your online application.

After your application has been processed, you will receive your Medicare card in the mail.

For more information about applying for Medicare without simultaneously applying for Social Security benefits, visit the Social Security Administration website.