Medicare and Social Security: how they work together.
If you're collecting Social Security retirement benefits, your Medicare Part B premium ($185 in 2026) is automatically deducted from your monthly Social Security check. If you're not yet collecting Social Security, you'll receive a quarterly bill from Medicare.
Auto-enrollment if you're collecting Social Security
If you're already receiving Social Security retirement or Railroad Retirement Board benefits 4 months before turning 65, you're automatically enrolled in Medicare Parts A and B. You'll receive your Medicare card 3 months before your 65th birthday. No application needed. Part B premium starts being deducted from your Social Security check the month you turn 65.
Manual enrollment if not yet on Social Security
If you're not yet collecting Social Security, you must enroll in Medicare yourself. Apply during your Initial Enrollment Period (IEP) — the 7-month window starting 3 months before your 65th birthday month. Apply online at ssa.gov/medicare, by phone (1-800-772-1213), or in person at a local SSA office.
Hold Harmless rule
The 'Hold Harmless' provision protects most Social Security recipients from Part B premium increases that would exceed their annual Social Security cost-of-living adjustment (COLA). About 70% of Medicare beneficiaries are protected. Hold Harmless does not apply to: new Medicare enrollees, those subject to IRMAA, and dual eligibles whose Part B premium is paid by Medicaid.
How Medicare premiums affect your Social Security check
If you collect Social Security and have Medicare Part B, your monthly check is reduced by the Part B premium ($185 in 2026, plus IRMAA if applicable). If you also have Part D, you can have the Part D premium deducted from Social Security too — though many people pay Part D directly to the carrier instead.
Working at 65 — Social Security and Medicare timing
You can collect Social Security as early as age 62, and you become Medicare-eligible at 65. Many people delay Social Security past 65 to maximize their benefit (which grows 8% per year delayed past Full Retirement Age until age 70). You can be on Medicare without collecting Social Security — just apply for Medicare manually and you'll be billed quarterly for Part B.
Part B premium changes annually
Each fall, Medicare announces the new Part B premium for the following year. The 2026 standard Part B premium is $185.00. Social Security typically announces the COLA in October, which affects how much of the Part B increase you actually feel. The Hold Harmless provision can reduce or eliminate the increase for most existing enrollees.
Frequently asked questions
Yes, if you're collecting Social Security. The Part B premium ($185 in 2026, plus any IRMAA surcharge) is deducted from your monthly Social Security check before it's deposited. You'll see this as a line item on your annual SSA-1099. Part D premium can also be deducted if you choose.
Yes. You become Medicare-eligible at 65 regardless of when you start Social Security. If you're not yet collecting Social Security, apply for Medicare manually at ssa.gov/medicare. You'll be billed quarterly for Part B (about $555 per quarter in 2026).
Hold Harmless protects most existing Social Security recipients from Part B premium increases that would exceed their annual COLA. If your COLA increase is smaller than the Part B premium increase, your Part B premium is capped so your net Social Security check doesn't decrease. About 70% of Medicare beneficiaries are protected.
Yes — if your spouse hasn't worked 40 quarters (10 years) themselves, they can qualify for premium-free Part A based on your work record once they turn 65 and you're at least 62. Part B premium is the same regardless of work record.
Free 14-minute Medicare review.
A licensed advisor reviews your situation and walks you through every option. Free, no obligation.
Call (866) 534-1886Or request a callback · Mon–Fri 8a-8p ET, Sat 9a-2p ET