Medicare and Social Security are not the same, though many people confuse them because both are federal programs you may receive at or near retirement age

Social Security is a monthly income program. It replaces a portion of the wages you earned during your working years. You pay into it through payroll taxes, and when you reach a certain age (or if you become disabled or have dependents), you receive monthly checks.

Medicare is health insurance. It covers hospital care, doctor visits, prescription drugs, and preventive services. You also pay into Medicare through payroll taxes, but instead of sending you money, it pays your medical providers when you receive care.

You can receive one, both, or neither of these programs depending on your work history and age. Many people do receive both — but they serve completely different purposes.

Key Takeaways

  • Social Security provides monthly cash income based on your work history; Medicare is health insurance that pays medical providers, not you.
  • You can receive Social Security without Medicare, or Medicare without Social Security, depending on your age and work record.
  • Social Security may be able to access typically begins at age 62 (with reduced payments) or age 67 to 70 (with full or increased payments); Medicare may be able to access typically begins at age 65.
  • Both programs are funded through payroll taxes, but the money goes into separate trust funds and serves separate purposes.
  • You enroll in Social Security and Medicare through different processes and at different times in your life.

How Social Security Works

Social Security is a retirement, disability, and survivor insurance program. During your working years, you and your employer each pay 6.2% of your wages into the Social Security trust fund. When you reach retirement age, become disabled, or pass away, the program pays monthly benefits to you or your family members.

The amount you receive depends on how much you earned over your lifetime and when you claim benefits. If you claim at age 62, your monthly payment is smaller than if you wait until age 67 or 70. Most people who worked for at least 10 years are may have access to to their own retirement benefit. Spouses and children of retired or disabled workers may also receive benefits based on that worker's record.

Social Security is not means-tested, meaning your income or assets do not affect whether you can receive it — only your work history and age matter. You receive the money as a direct deposit or check each month, and you can spend it however you choose.

How Medicare Works

Medicare is a health insurance program run by the federal government. During your working years, you and your employer each pay 1.45% of your wages into the Medicare trust fund. When you turn 65, you become may be able to access to enroll in Medicare, regardless of whether you have claimed Social Security.

Medicare has four parts. Part A covers hospital stays, skilled nursing facility care, and some home health services. Part B covers doctor visits, outpatient services, and medical equipment. Part D covers prescription drugs. Part C, also called Medicare Advantage, is an alternative way to receive Parts A and B through a private insurance company.

When you use Medicare, the program pays your hospital or doctor directly. You do not receive a check. Instead, you may pay a copay, coinsurance, or deductible depending on the service and your coverage. Medicare does not cover everything — dental, vision, and hearing care are typically not included.

When You Can Start Receiving Each Program

Social Security and Medicare have different may be able to access ages. You can claim Social Security as early as age 62, though your monthly payment will be permanently reduced. If you wait until your full retirement age (between 66 and 67 depending on your birth year), you receive your full benefit amount. If you delay until age 70, your benefit increases by about 8% per year.

Medicare may be able to access begins at age 65 for most people. You do not have to claim Social Security to enroll in Medicare — they are separate decisions. Some people claim Social Security at 62 and delay Medicare until 65. Others delay Social Security until 70 but enroll in Medicare at 65. The timing of one does not affect the other.

If you are disabled or have end-stage renal disease or ALS (amyotrophic lateral sclerosis), you may become may be able to access for both programs before age 65. People who receive Social Security Disability Insurance (SSDI) automatically become may be able to access for Medicare after 24 months of receiving disability benefits.

How They Are Funded

Both programs are funded through payroll taxes, but the money goes into separate trust funds. Your Social Security tax (6.2% of wages) goes into the Social Security Trust Fund. Your Medicare tax (1.45% of wages) goes into the Hospital Insurance Trust Fund and the Supplementary Medical Insurance Trust Fund.

Self-employed people pay both the employee and employer portions of these taxes — 12.4% for Social Security and 2.9% for Medicare. If you earn more than a certain amount (which changes yearly), you may pay an additional 0.9% Medicare tax.

The money you pay in does not sit in an account with your name on it. Instead, current payroll taxes pay benefits to current retirees and disabled workers. This is called a pay-as-you-go system. When you retire, future workers' taxes will help pay your benefits.

How to Enroll in Each Program

You enroll in Social Security and Medicare through different processes. To claim Social Security retirement benefits, you contact Social Security directly by visiting your local Social Security office, calling 1-800-772-1213, or creating an account at ssa.gov. You can file for benefits up to four months before you want them to start.

To enroll in Medicare, you contact Medicare directly through Medicare.gov, by calling 1-800-MEDICARE (1-800-633-4227), or by visiting your local Social Security office. You can enroll during your Initial Enrollment Period, which begins three months before the month you turn 65 and ends three months after. If you miss this window, you may pay a late enrollment penalty.

If you are already receiving Social Security when you turn 65, you will receive information about Medicare enrollment automatically. If you are not yet receiving Social Security, you must enroll in Medicare separately.

What Happens If You Receive Both

Most people who reach age 65 or older receive both Social Security and Medicare. Your Social Security check arrives each month as income. Your Medicare coverage pays your medical providers when you receive care. The two programs work alongside each other but remain separate.

If you have low income and limited resources, you may be may be able to access for programs that help pay your Medicare premiums and cost-sharing. Medicaid, a separate program run by states, sometimes covers costs that Medicare does not. The Medicare Savings Program and Extra Help program are two examples of information that may be available depending on your state and income.

Your Social Security benefit does not change based on your Medicare enrollment, and your Medicare coverage does not depend on how much Social Security you receive. They operate independently.

Frequently Asked Questions

Can I get Medicare without Social Security?

Yes. Medicare may be able to access at age 65 is based on your work history, not on whether you have claimed Social Security. You can enroll in Medicare at 65 and delay claiming Social Security until 70 if you choose. However, if you are receiving Social Security Disability Insurance, you automatically become may be able to access for Medicare after 24 months.

Can I get Social Security without Medicare?

Yes. You can claim Social Security retirement benefits at 62 or later without enrolling in Medicare. However, if you delay Medicare past age 65 without a valid reason (such as employer coverage), you may pay a late enrollment penalty when you do enroll. You must enroll in Medicare by age 65 or face this penalty, even if you do not claim Social Security.

Do I have to claim Social Security at 65?

No. You can claim Social Security anytime between age 62 and 70. Claiming earlier means a smaller monthly payment for life. Waiting until 70 means a larger monthly payment. Your Medicare enrollment at 65 is separate and does not depend on when you claim Social Security.

What if I worked but did not pay enough into Social Security?

You need at least 40 work credits (roughly 10 years of work) to receive your own Social Security retirement benefit. If you have fewer credits, you may not be may have access to to benefits based on your own record. However, you may still be may have access to to Medicare at 65 if you have at least 30 work credits, or you may be able to receive benefits based on a spouse's or ex-spouse's record.

Does my Social Security income count toward Medicare costs?

Your Social Security income does count as income for purposes of determining whether you may have access to for programs that help pay Medicare costs, such as the Medicare Savings Program or Extra Help. However, Social Security does not directly pay your Medicare premiums unless you choose to have your premium deducted from your Social Security check.