Medicare costs on SSDI are different from what working people pay
When you receive SSDI, you become automatically enrolled in Medicare after you have been on SSDI for 24 months. The amount you pay depends on which parts of Medicare you use and your income level. Most people on SSDI pay little or nothing for Part A (hospital insurance), but Part B (medical insurance) has a monthly premium that comes directly out of your SSDI check.
The exact cost changes every year. For 2024, the standard Part B premium is $164.90 per month, but you may pay less if your income is below certain thresholds, or more if your income is higher. Some people on SSDI may have access to for Extra Help, a program that covers Part B premiums and other costs entirely.
Unlike working people who pay Medicare taxes from their paychecks, you do not pay anything extra to "earn" Medicare on SSDI. The program is built into your SSDI status once you hit the 24-month mark.
Key Takeaways
- You pay nothing for Part A (hospital insurance) in almost all cases, and nothing for the first 24 months of SSDI before Medicare even starts.
- Part B (medical insurance) costs around $165 per month in 2024, but the exact amount depends on your income and changes yearly.
- If your income is very low, you may pay $0 for Part B through the Extra Help program or your state's Medicaid.
- Your Part B premium is deducted automatically from your SSDI payment each month, so you do not receive a separate bill.
- Part D (prescription drug coverage) is optional and costs vary by plan, but you can find plans with $0 premiums in most areas.
Part A: Hospital insurance costs on SSDI
Part A covers hospital stays, skilled nursing care, hospice, and home health services. Most people on SSDI pay $0 per month for Part A because they do not have enough work history to owe the premium. You only pay a Part A premium if you worked long enough to build up credits but did not work long enough to may have access to for Social Security retirement benefits — a situation that is uncommon on SSDI.
Even if you do owe a Part A premium, it is usually much lower than Part B. The 2024 premium for people who do not may have access to for free Part A is $278 per month, but again, most SSDI recipients do not pay this.
Part A does have deductibles and copays when you actually use hospital services. In 2024, you pay $1,632 for the first 60 days of a hospital stay, then smaller amounts for days 61 through 90, and more for days beyond that. These costs come out of your pocket at the time of service, not as a monthly premium.
Part B: Medical insurance and the monthly premium
Part B covers doctor visits, outpatient care, medical equipment, and preventive services. This is where most SSDI recipients see a monthly cost. The standard 2024 premium is $164.90 per month, but your actual premium may be different based on your income from the previous two years.
If your income is above a certain threshold (in 2024, $97,000 for a single person), you pay a higher premium called an Income-Related Monthly Adjustment Amount (IRMAA). This can range from $164.90 to $560.50 per month depending on how much income you reported. The Social Security Administration sends you a notice each year showing your premium for the coming year.
Your Part B premium is taken out of your SSDI check automatically. You do not pay it separately. If your SSDI payment is smaller than your premium, Social Security will still deduct it, which means your net payment becomes very small or even zero in rare cases.
Part B also has a yearly deductible ($240 in 2024) and a 20% copay for most services after you meet the deductible. These are separate from the monthly premium.
Part D: Prescription drug coverage and costs
Part D is optional coverage for prescription medications. You do not have to take it, but if you go without it and later want to enroll, you may face a late enrollment penalty that increases your premium permanently. For this reason, most people on SSDI enroll in a Part D plan even if they do not use many medications.
Part D premiums vary widely by plan and by location. In 2024, many plans have $0 monthly premiums, while others cost $5 to $100+ per month. You choose your plan during the annual enrollment period (October 15 to December 7), and the plan you pick determines what you pay.
When you fill a prescription, you also pay a copay or coinsurance amount that depends on the drug and your plan. Some medications are covered at low cost, while others may not be covered at all. Your plan's formulary (the list of covered drugs) tells you what you will pay for each medication.
Extra Help and Medicaid can reduce or eliminate your costs
Extra Help is a federal program that pays Part B and Part D costs for people with low income and limited resources. If you receive SSDI, you may already may have access to. In 2024, you can have up to $20,000 in resources (savings, investments, property other than your home) and still be may be able to access. The income limit varies by state but is roughly $1,500 to $2,000 per month.
To explore for Extra Help, contact Social Security at 1-800-772-1213 or visit your local Social Security office. You can also explore online at ssa.gov. The process takes about 15 minutes, and you will find out within days whether you may have access to.
If you also may have access to for Medicaid (your state's program for low-income people), Medicaid can pay your Part B premium, Part D premium, and some of your out-of-pocket costs. Medicaid rules vary by state, so contact your state's Medicaid office to learn what you may may have access to for. Many people on SSDI receive both Medicare and Medicaid, a situation called "dual may be able to access."
What happens to your Medicare costs if your SSDI payment changes
If your SSDI payment increases or decreases, your Medicare premium may change too — but not when ready. Social Security uses your income from two years ago to calculate your Part B premium (and any IRMAA). This means if you earn money or receive other income this year, you will not see the premium increase until two years from now.
If your income drops significantly — for example, if you stop working or lose a source of income — you can ask Social Security to recalculate your premium based on your current year's income instead of the prior two years. This is called a life-changing event appeal. You must request it within 60 days of the event that changed your income.
Your Part A premium (if you have one) does not change based on income. Part D premiums are set by insurance companies and can change year to year, but you can switch plans during open enrollment if a cheaper option becomes available.
Frequently Asked Questions
Do I have to pay for Medicare if I am on SSDI?
You do not pay anything for the first 24 months of SSDI. After 24 months, you are enrolled in Medicare automatically. Part A is free for almost everyone on SSDI. Part B costs around $165 per month in 2024, taken from your SSDI check. Part D (prescription drugs) is optional but recommended.
What if my SSDI payment is smaller than my Medicare premium?
Social Security will still deduct your Part B premium from your check, even if it means your net payment becomes very small. This is rare, but if it happens to you, contact Social Security to discuss your options. You may be able to appeal your premium amount or explore Extra Help.
Can I drop Medicare Part B to save money?
You can drop Part B, but you will face a late enrollment penalty if you want to sign up again later. The penalty is 10% of the standard premium for each year you were without coverage, and it is permanent. Most people on SSDI keep Part B even if they do not use it much, to avoid this penalty.
How do I know if I may have access to for Extra Help?
You likely may have access to if you receive SSDI and have less than $20,000 in savings and other resources. Income limits vary by state but are roughly $1,500 to $2,000 per month. Call Social Security at 1-800-772-1213 to explore, or visit ssa.gov. The process takes about 15 minutes.
Does my state's Medicaid cover Medicare costs?
Many states have programs that pay Medicare premiums and copays for people on SSDI with low income. Rules vary by state. Contact your state's Medicaid office or call 1-800-MEDICARE to find out what your state offers and whether you may have access to.