Medicare and Social Security: How do they work and how do they differ?

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How each government program helps you

If you are approaching your 60s and have not applied for Social Security or Medicare, you might have questions about how the two programs function or how they benefit you.

Medicare and Social Security are government programs designed as safety nets for U.S. workers, whether as an aid to retirement, disability or losing a spouse. The two often work together in offering complementary benefits.

What they are

Social Security: Administers retirement, disability, survivor, and family benefits. Social Security also provides unique numbers to individuals that keep record of their work and financial transactions, ultimately determining eligibility for government services. The Social Security Administration manages eligibility for Social Security and for parts A and B of Medicare.

If you have a medical condition that prevents you from working for 12 months or longer, or you have a terminal illness, Social Security may be able to provide support. The program also supports children who have a condition that significantly affects their daily activities.

Medicare: Provides health insurance for people 65 and older. People under 65 may also qualify for Medicare if they have certain disabilities, end-stage renal disease or Lou Gehrig’s disease. The Centers for Medicare and Medicaid Services handles enrollment in Medicare parts C and D, and may also collect premiums for parts A and B if they weren’t deducted from Social Security benefits.

Most people at the age of 65 qualify for Part A (hospital insurance) and Part B (medical insurance). They can also purchase a supplement insurance plan to cover out-of-pocket costs or enroll in a Medicare Advantage plan as an alternative.

Eligibility

Social Security: To be eligible for Social Security, you must be between 62 and 70 years of age, blind or disabled.

Medicare: To be eligible for Medicare, you must be at least 65 years old, have a disability or have been diagnosed with end-stage renal disease or Lou Gehrig’s disease.


Applying

Social Security: You can apply for Social Security starting at age 62. The Social Security Administration will calculate your payment by looking at how much you've earned throughout your life. The amount will be higher the longer you wait to apply, up until age 70.

Medicare: If you are receiving Social Security services by age 65, you will likely be automatically enrolled. If not, you will have to enroll at or beyond age 65.


How they work together

Enrollment: Social Security handles the enrollment for both retirement and Medicare. If you apply to get retirement benefits at least four months before you turn 65, you’ll automatically receive Medicare Part A (hospital insurance) and Part B (medical insurance) when you turn 65 – though you can opt out of Medicare Part B if it is not needed.

You will also automatically be enrolled in Medicare Part A if you enroll in Social Security anytime past age 65. However, if you are age 65 or older, and are not taking Social Security benefits, you will need to take active steps to enroll in Medicare. You must enroll through Social Security – either in person or online.

Billing: If you enroll in Medicare and are not yet taking Social Security Benefits, you will receive a quarterly bill through the Center for Medicare and Medicaid Services. If you are taking Social Security Benefits when you enroll in Medicare, or begin taking them once you are on Medicare, your monthly premium for Medicare Part B (and A, if applicable) will be deducted out of your Social Security check; you will see this amount reflected on your statement each month. You can also elect to have your monthly Medicare Part D (prescription plan) premium taken out of your Social Security check.

Regardless of what your retirement and insurance goals are, Everence can help you find the path that best suits you. Contact a representative to start working on your retirement and insurance journeys.

Sharon Hernandez, Editorial Content Specialist
Author Sharon Hernandez
Editorial Content Specialist
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Learn more about Medicare

Deciding how and when to enroll in Medicare is one of the most significant decisions you will make about your health care as you move toward retirement. Get the resources you need to move forward with confidence.