Will I Automatically Get Medicare with Social Security Benefits?

If you’re receiving Social Security benefits, you’ll likely be automatically enrolled in Medicare Part A and Part B. Discover how these benefits work together and whether they cover all your health needs.

Will You Automatically Receive Medicare Coverage with Social Security Benefits?

In some cases, yes.

If you’re already getting benefits from Social Security or the Railroad Retirement Board (RRB), you’ll automatically be enrolled in both Part A and Part B starting the first day of the month you turn 65. If your birthday is on the first day of the month, Part A and Part B will begin on the first day of the prior month.

Suppose you’re under 65 and have a disability. In that case, you’ll automatically get Part A and Part B after you get disability benefits from Social Security or certain disability benefits from the RRB for 24 months.

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How Do Social Security and Medicare Work Together?

Social Security benefits provide partial replacement income if you’re a qualified retiree or disabled person and for spouses, children, and survivors. The Social Security Administration determines the amount that you receive.

Medicare is a United States federal health insurance program that reduces the cost of healthcare services. Medicare plans cover people 65 or older, younger people who meet eligibility requirements, and individuals with certain diseases.

Although the Centers for Medicare & Medicaid Services (CMS) is the agency in charge of the Medicare program, Social Security processes your application for Original Medicare (Part A and Part B).

Medicare Eligibility

You are eligible for premium-free Medicare Part A if you are age 65 or older and you or your spouse earned 40 credits or worked and paid FICA taxes for at least ten years.

You don’t need to apply for Medicare Part A and B if you already receive Social Security retirement benefits. Enrollment will happen automatically. For example, if you took retirement benefits at 62 instead of full retirement age, you’ll be enrolled in Medicare three months before your 65th birthday. You could also be automatically enrolled if you’ve received Social Security Disability Insurance (SSDI) for 24 months.

You should receive your red, white, and blue Medicare card in the mail three months before your 65th birthday. That serves as proof of enrollment.

What Do Medicare Part A and B Cover?

Medicare Part A

Medicare Part A (hospital insurance) is usually premium-free and covers inpatient care in a hospital, care in a skilled nursing facility, short-term nursing home care, hospice care, and home health care. If you’re in a Medicare Advantage plan, that plan may have different rules. However, your plan must give you the same coverage as Medicare Part A.

Medicare Part B

Medicare Part B has an extra monthly cost and covers outpatient care, preventative services, ambulance services, and durable medical equipment. Part B is similar to standard health insurance and has a premium.

A monthly standard base rate premium is set annually by the IRS. Most people pay the standard Part B premium amount ($185.00 in 2025). Suppose your Modified Adjusted Gross Income (MAGI), as reported on your IRS tax return from two years ago, is higher than a certain amount. In that case, you’ll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your standard base premium.

The Part B premium will be automatically deducted from your benefit payment if you receive a Social Security, Railroad Retirement Board, or Office of Personnel Management benefit. You’ll receive a monthly or quarterly premium bill if you don’t have your premium automatically deducted.

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What Does Medicare Part B Cover?

Medicare Part B covers doctor’s visits, lab tests, and coverage for orthopedic, cardiology, radiology, and other specialists from A to Z—including inpatient and outpatient mental health care. Screening for common medical conditions, annual wellness checks, vaccinations, and second opinions about a medical issue are also covered by Part B. Part A and B generally cover 80% of Medicare-approved services. You would be responsible for the remaining 20% coinsurance.

What If Part A and Part B Don’t Cover What I Need?

Speak with your doctor or health care provider to determine if Medicare Part A and B cover your needed care. If your care or prescriptions are not covered, you might choose a Medicare Advantage plan (Part C), Medicare Advantage Prescription Drug plan (MAPD), or a Medicare Prescription Drug plan (Part D).

Whether online or by phone, Connie Health can help you determine if a Medicare Advantage (Part C) or Medicare Prescription Drug Plan (Part D or Medicare Advantage Prescription Drug plan) could save money and provide the care you need. There are specific times when you can sign up for these plans or make changes to your coverage. To ensure you don’t miss the window for signing up or making changes, call and speak with a local licensed Connie Health agent at (623) 223-8884.