Medicare premiums are deducted from your Social Security check by default, but you can choose a different payment method

When you turn 65 and enroll in Medicare Part B (medical insurance) and Part D (prescription drug coverage), the standard setup is for those premiums to be taken directly from your monthly Social Security payment. This happens automatically unless you tell Medicare otherwise. You are not required to use this method — you can pay your premiums separately by mail, phone, or online instead.

The automatic deduction is called direct deduction from Social Security, and it applies to most people who receive Social Security and enroll in Medicare at the same time. However, there are situations where this does not happen automatically, and there are reasons you might want to change it.

Key Takeaways

  • Medicare Part B and Part D premiums are deducted from your Social Security check by default, but you can request a different payment method at any time.
  • If you do not receive Social Security, you will receive a separate Medicare bill by mail and must pay it yourself.
  • You can switch from Social Security deduction to paying by mail, phone, or online, or switch back, by contacting Medicare directly.
  • If your Social Security payment is too small to cover your Medicare premiums, Medicare will hold the full premium and bill you for the difference.
  • Part A (hospital insurance) premiums are rarely deducted from Social Security because most people do not pay a Part A premium.

When Medicare premiums are automatically deducted from Social Security

The automatic deduction happens when you are receiving a Social Security benefit and you enroll in Medicare Part B or Part D. Medicare coordinates with Social Security to set this up without you having to do anything extra. Your Social Security payment is reduced by the amount of your premium each month.

This applies whether you enroll in Medicare at 65 or later. If you delay Social Security but enroll in Medicare, you will still receive a separate bill for Medicare premiums because you are not yet receiving Social Security payments to deduct from.

When Medicare premiums are NOT deducted from Social Security

If you do not receive a Social Security benefit, Medicare cannot deduct premiums from it. This includes people who are still working and have not yet claimed Social Security, people who receive Railroad Retirement benefits instead of Social Security, and people who receive Veterans benefits. In these cases, Medicare sends you a bill by mail, usually monthly.

You can still choose to pay online or by phone even if you are not receiving Social Security. Contact Medicare at 1-800-MEDICARE to set up a payment method other than mail.

How to change your payment method

You do not have to accept automatic deduction from Social Security. You can switch to paying by mail, phone, or online at any time. Call Medicare at 1-800-MEDICARE and tell them you want to change your payment method. You can also make this change online through your Medicare account at Medicare.gov.

The change usually takes effect the month after you request it. If you switch away from Social Security deduction, you will receive a bill by mail or can set up online payments. If you later want to go back to Social Security deduction, you can request that too — there is no limit to how many times you can switch.

What happens if your Social Security payment is smaller than your premium

If your monthly Social Security benefit is less than your Medicare premium, Medicare will deduct the full amount of your Social Security payment and bill you for the remaining balance. For example, if your Social Security payment is $800 and your Part B premium is $165, Medicare takes the full $800 and sends you a bill for the difference.

This situation is called a hold. You will receive a separate bill from Medicare for the amount not covered by Social Security. You can pay this bill by mail, phone, or online. If you find yourself in this position regularly, switching to a separate payment method might be easier to manage.

Part A premiums and Social Security deduction

Part A (hospital insurance) premiums are rarely deducted from Social Security because most people do not pay a Part A premium at all. If you or your spouse worked for at least 10 years while paying Medicare taxes, you receive Part A for free at 65. You only pay a Part A premium if you did not work long enough to may have access to for free coverage.

If you do owe a Part A premium, it can be deducted from Social Security using the same process as Part B and Part D. Contact Medicare to set this up or to change your payment method.

Income-related premiums and Social Security deduction

Some people pay higher Medicare premiums based on their income. These income-related monthly adjustment amounts (IRMAA) are added to your Part B and Part D premiums. These higher amounts are also deducted from Social Security by default if you receive Social Security.

If your income changes, your IRMAA may change too. Medicare sends you a notice if your premium increases or decreases. You can appeal an IRMAA information if you believe your income has dropped due to a life event like retirement or loss of a spouse.

Frequently Asked Questions

Can I refuse to have Medicare deducted from Social Security?

Yes. You can request a different payment method by calling 1-800-MEDICARE or through your Medicare account online. You can pay by mail, phone, or automatic bank withdrawal instead. The change takes effect the following month.

What if I do not receive Social Security yet?

Medicare will send you a bill by mail. You can also set up online or phone payments through Medicare. Once you start receiving Social Security, you can request that future premiums be deducted from your benefit.

Will switching payment methods affect my Social Security benefit amount?

No. Your Social Security benefit stays the same whether premiums are deducted or paid separately. The only difference is how and when you pay your Medicare premiums.

Can I switch back to Social Security deduction after I stop it?

Yes. You can switch payment methods as many times as you want. Call 1-800-MEDICARE or log into your Medicare account to make the change.

What if I owe back Medicare premiums?

Contact Medicare at 1-800-MEDICARE to set up a payment plan. You can pay by mail, phone, or online. Medicare may also deduct unpaid premiums from your future Social Security payments or tax refunds.