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Are Social Security and Medicare the same thing?

Louise Norris // August 26, 2021

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Q: I’ve heard members of Congress talking about raising the eligibility age for Social Security and Medicare, and also about privatizing them. The proposals often sound the same. Are Social Security and Medicare the same thing?

A: They’re not the same thing, but they do have many similarities, and most older Americans receive benefits simultaneously from both programs.

Social Security, which was enacted in 1935, is a government-run income benefit for retirees who have worked – and paid Social Security taxes – for at least ten years. Social Security also provides spousal and survivor benefits, and people under 65 are eligible for benefits if they’re disabled. (Social Security’s official name is “Old Age, Survivors, and Disability Insurance” or OASDI.)

Medicare, enacted in 1965, is also a government-run program for older Americans, designed to provide health insurance coverage for anyone 65 or older who has worked – and paid Medicare taxes – for at least ten years. (You can purchase Medicare coverage if the work history is less than ten years, and coverage can also be obtained based on a spouse’s work history). Medicare also provides health insurance benefits to younger people who are disabled, or who have kidney failure or ALS.

How does Medicare get confused with Social Security?

But some of the confusion stems from the fact that the Social Security Administration (SSA) is responsible for determining eligibility for Medicare and handling many of the program’s administrative functions, including enrollment. The SSA also handles the administration of Social Security benefits.

Since eligibility for both Medicare and Social Security benefits are managed by the SSA, people who begin receiving Social Security retiree benefits prior to age 65 will be automatically enrolled in Medicare once they turn 65.

Eligibility for the two programs

For people who are aging into Social Security and Medicare (as opposed to qualifying for benefits due to a disability), eligibility ages vary between the two programs. Beneficiaries qualify for Medicare when they turn 65, with a seven-month enrollment window that straddles the month they turn 65.

But there’s significantly more flexibility in terms of eligibility for Social Security. You can elect to begin receiving Social Security payments as early as age 62, but the earlier you begin collecting benefits, the lower your monthly check will be. Waiting to claim Social Security benefits until age 70 results in the highest monthly income payments.

Both Social Security and Medicare are available regardless of income, so benefits are provided to wealthy Americans as well as those with lower incomes. That’s in contrast with Medicaid, which is only available to low-income Americans.

Funding for Social Security and Medicare

Both programs are primarily funded by payroll taxes, which are split evenly between employees and employers (self-employed workers pay both portions, but can deduct half of the self-employment tax from their business income). The Social Security tax rate is higher, but there’s an upper income limit above which Social Security taxes are not levied. The Medicare tax rate is lower, but it applies to all wages. Together, Medicare and Social Security payroll taxes are known as FICA taxes (Federal Insurance Contributions Act taxes).

Lawmakers on both sides of the aisle have proposed a variety of reforms for both Social Security and Medicare, but Republicans are much more likely to focus on privatization, means testing, and increasing the age at which people become eligible for benefits.

Former Speaker of the House, Paul Ryan, proposed various Medicare reforms in budget proposals during his time in office, including privatization, means testing, and raising the eligibility age to 67. Not surprisingly, Ryan’s proposals failed to gain bipartisan support, but have remained quite popular with Republicans.

Similar proposals have been advanced regarding Social Security, with GOP lawmakers often calling for an increase to the full retirement age for Social Security. (It’s currently age 67 for people born in 1960 or later.) They’ve also proposed privatizing the program, adding means testing, or a combination of all three approaches.

Some Democrats have proposed expanding the Social Security tax so that it applies to all income, a move that would increase revenue and stabilize the program without the need to reduce benefits.

So while there are certainly similarities between Medicare and Social Security – and similarities in terms of how politicians have proposed reforming both programs – they are not the same thing. Most elderly Americans are beneficiaries of both programs, receiving a monthly check from Social Security to provide retirement income, along with health insurance from Medicare.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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Vanessa sharp
2 years ago

Could I plz upgrade my Medicare card as it’s expired

2 years ago
Reply to  Vanessa sharp

Vanessa, you’d need to contact CMS for new card. 800-MEDICARE (800-633-4227)

Deborah Thiagarajan
2 years ago

a question. I am a US citizen and am.76. I live in India and spend upto three months a year in the US to stay with my children. I had only 7 years of ss and only 4 years of payments to medicare form the US so I have no coverage. Since the enactment of fatca from 2013 I have been paying U.S. taxes. I still earn a salary less than $100,000 from an Indian company but they have not deducted for SS or medicare. Can I make medicare payments for the three plus missing years from my own funds and then be enrolled for medicare. I am afraid to come to the US without healthcare. How can I enrol in medicare?

Josh Schultz
2 years ago

Hi Deborah,

You don’t need to pay the full 10-years of Social Security taxes to qualify for Medicare, although it means you’ll need to pay more for Part A. This is good because in fact, you can’t pay those taxes for income that wasn’t covered by FICA tax. Your situation is difficult in that you seek coverage for a limited period each year. Using Medicare coverage during your visits would require remaining continuously enrolled (and paying premiums) year-round. If you choose to pursue this route, please let us know. Another option might be to try travel insurance: (Although the article here is about people traveling outside of the US, you’d be purchasing coverage for the purpose of doing the opposite.)

Also note that if you’re planning at some point to relocate permanently to the US, you should enroll in Medicare now so you don’t incur higher penalties for late enrollment. One of us would be happy to explain in further detail if this is the case.

2 years ago

My mother received a letter recently stating her medicare was no longer covered by the government or by SS. it said she makes $1300 in SS and $141.00 will now be deducted for Medicare. I don’t understand where this change is coming from. Any ideas?

Josh Schultz
2 years ago
Reply to  Gail

Sounds like your mother had a Medicare Savings Program (MSP). This pays your Part B premium for you. Contact your Medicaid office to reapply:

2 years ago

Thank you very helpful.

Brett P Hardaway
2 years ago

I am 73 and have been getting my SSI and Medicare for some years now. I started off on these when I was 55 due to becoming I’ll and couldn’t work. At 62 was then changed over regular SSI and Medicare ( mean I was no longer classes as disabled). I have recently been diagnosed with COPD and have been admitted to Hospital a couple of times. I am continually on medication and need oxygen. I do have Cigna Advantage Plan to help with Doctors and Medications. And get extra help which was started BEFORE I was Diagnosed with COPD. I have some other medical conditions but can’t afford to go to Specialist.
How can I find out if I am still paying to My Medicare (144.00, something like that) and if I can update the extra help. Any help would be greatly appreciated, thank you.

Josh Schultz
2 years ago

This article should answer some of your questions:

I would also clarify that I believe you’re referring to Social Security Disability Insurance (SSDI) and not SSI, which a program for people with very low incomes.

Ruth Barbour
2 years ago

I’m 60 but was under 60 when I got my soical security. I got about 1000 a month then it droped to 700& some change. At that time they said it was medacare.i saw on TV u could get that $ back .I filed and they said I would get the $ back but to this date I haven’t .I have it in writing and after questioning then I got a letter saying denied .because I didn’t get all paper work to them .I have dated papers for all that I turned in and the paper work they ask for.guessthey thought I wouldn’t copy and stampdate all infro..thank you Ruth barbour

Josh Schultz
2 years ago
Reply to  Ruth Barbour

If you believe your Medicare Savings Program application was wrongly denied (and that you were, in fact, eligible and had submitted all of the required documents), you can appeal the denial by requesting a “Fair Hearing.” This is where your state’s agency reviews its earlier decision. You can request this by calling the agency you worked with to apply.

Timothy Murphy
2 years ago

I started receiving retirement social security at age 62 am I eligible for medicare

Josh Schultz
2 years ago
Reply to  Timothy Murphy

Your Social Security is through the ‘retirement’ benefit and not disability — which means you won’t qualify for Medicare until you turn 65.

2 years ago

I am a retired 64 YO American and Canadian citizen living permanently in the US. I worked for 11 quarters in the US and 20 years in Canada. I have contributed to SS and CPP respectively during my working years. Now living in the US, I want to collect SS (or CPP). Am I eligible for SS? Am I eligible for Medicare?

2 years ago
Reply to  Sharon

We recommend that you contact the Social Security Administration and the Canada Pension Plan for specific details about your eligibility in one or both programs.
But in general, you need 40 quarters of work in the US (paying Medicare and Social Security taxes) in order to qualify for Social Security retirement benefits:
Once you turn 65, assuming you’ve lived continuously in the US for at least five years, you’ll be able to buy into the Medicare system. But unless you’ve worked at least 40 quarters in the US, you’ll have to pay a premium for Medicare Part A (in addition to the premium for Medicare Part B, which everyone pays). The current premium for Part A is $252/month if you’ve worked at least 30 quarters in the US, and $458/month if you’ve worked fewer than 40 quarters.

1 year ago

Is a Medicare card proof of social security. Is there 1 card for both

1 year ago

I needed to find out if a person has been on SSI disability for about 7 years or so guessing, 48 years old. She has medicade which is fine except for a few things Medicade don’t cover which is eye exam and glasses, for adults, hearing, or dentures. Which is really needed especially glasses. I heard some people talking about Medicare advantage plan, but it’s got to be I believe a certain kind of disability! I also heard if you been on social security for over 2 years? But didn’t say about SSI. So I really needed info or something to go on.

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