Is Medicare Mandatory for Social Security Disability Recipients?

If the Social Security Administration (SSA) approves you for disability insurance benefits (SSDI), you'll become eligible for Medicare coverage a year or two later (see our article on when disability recipients get Medicare coverage). Most people welcome Medicare coverage, but others are interested in declining the coverage so that Social Security doesn't take Medicare premiums out of their monthly SSDI benefits.

Is Medicare Mandatory If You're on Disability?

Social Security will automatically enroll most SSDI recipients in both Medicare Parts A and B before their 25th month of SSDI benefits. Three months before your coverage starts, the SSA will send you your new Medicare card, with your name, your Medicare number, and the dates your Part A and Part B coverage will start. The SSA will automatically deduct your monthly premiums from your Social Security check at the start of your 25th month of benefits, unless you send back your Medicare card.

You can decline Medicare Part B, which covers doctors' visits, x-rays, lab fees, surgery, and the like. If you don't want Part B, send the card back to Medicare (follow the instructions that come with the card). If you keep the card, you'll have Part B coverage, and Social Security will take the Part B premium out of your SSDI benefits.

Since Social Security takes money out of SSDI checks for Part B premiums, people who are covered under their spouse's employer-based health care insurance sometimes want to decline it. But be aware of penalties that may apply if you don't enroll in Part B when you're eligible.

Social Security won't automatically enroll you in Medicare Part D (which covers prescription drug costs), and you're not required to have it. But if you later try to enroll in Part D, you'll have to pay a late enrollment penalty (unless you wait to reenroll at age 65).

For practical purposes, you can't decline Medicare Part A, which covers hospitalization and skilled nursing stays. So Medicare Part A is mandatory if you're on disability, but Social Security doesn't take any money out of your SSDI payment for Part A premiums, so there's no reason not to have it.

If you decide to pay for Medicare Part B, you have the option of signing up for Medicare Part C. Being on Part C means that you'd have a Medicare Advantage plan that usually operates like an HMO. Most Medicare Advantage plans include drug coverage.

How Much Does Social Security Take Out for Medicare?

If you receive SSDI benefits, when you become eligible for Medicare, Social Security will take money out to pay for Medicare Part B premiums, in most cases. (The fact you were approved for SSDI makes you eligible for Medicare earlier than you otherwise would be, but it doesn't pay your premiums.)

For most people, Social Security deducts a Part B premium of $185 each month (in 2025). But for those with high income, the monthly premium can be double that amount due to a supplemental surcharge. (Here's a chart with the Part B surcharges.)

Disability recipients who have low income can receive help from their states in paying for Medicare premiums, which keeps Social Security from deducting any money from their SSDI benefit. The programs that help pay Medicare premiums are called Medicare Savings Programs. You can check with your local social service offices to determine if you might be entitled to help with your Medicare premiums.

Can SSI Recipients Receive Medicare?

People who receive disability benefits through the Supplemental Security Income (SSI) program don't qualify for Medicare insurance coverage—at least until they reach the age of 65 years old. (Until then, SSI recipients are eligible for Medicaid.) Upon turning 65, SSI recipients can receive Medicare based on age.

Learn more about the Medicare and Medicaid that comes with disability benefits.