Medicare costs on SSDI are lower than standard Medicare because you pay no monthly premium for Part A, and Part B premiums are deducted directly from your SSDI check

When you receive SSDI and become may be able to access for Medicare at age 65 (or after 24 months on SSDI if you are younger), you enter Medicare automatically. Your costs depend on which parts of Medicare you use and whether you have other income. Part A — hospital insurance — costs you nothing. Part B — medical insurance — has a monthly premium that comes out of your SSDI payment before you receive it. Part D — prescription drug coverage — is optional and costs extra if you choose it. Supplemental coverage (Medigap) is also optional and costs more.

The actual dollar amounts you pay change each year. The Social Security Administration publishes the current Part B premium in September for the following year. If you want to know your exact cost right now, you can call Social Security at 1-800-772-1213 and ask what your Part B premium will be, or log into your my Social Security account online.

Key Takeaways

  • Part A hospital insurance costs nothing when you are on SSDI; you pay only for Part B medical insurance and any optional coverage you choose.
  • Your Part B premium is deducted from your SSDI payment each month, so you never write a separate check.
  • Part B premiums increase each year and are based on your income from two years prior, so higher earnings in past years can raise what you pay now.
  • If your SSDI payment is very small, Social Security will not deduct the full Part B premium; instead you will owe the difference directly to Medicare.
  • Part D prescription drug coverage and Medigap supplemental plans are optional and cost extra on top of Part B.

Part A: Hospital Insurance (No Monthly Cost)

Part A covers inpatient hospital stays, skilled nursing facility care after a hospital stay, hospice, and some home health services. You pay nothing for the Part A premium itself because you earned it through your work history before becoming disabled.

You do pay out-of-pocket costs when you use Part A services. In 2024, if you are admitted to a hospital, you pay a deductible for each benefit period (the amount changes yearly). After that, Medicare covers most of the cost. If you stay in a skilled nursing facility after a hospital stay, you pay a daily coinsurance amount after the first 20 days. These costs are separate from your monthly premium and depend on how much care you actually use.

Part B: Medical Insurance (Monthly Premium Deducted from SSDI)

Part B covers doctor visits, outpatient care, medical equipment, and preventive services. The monthly premium is deducted automatically from your SSDI payment. In 2024, the standard Part B premium is $164.90 per month, but your actual premium may be higher or lower depending on your income.

Social Security uses your income from two years ago to calculate your Part B premium. If you earned more money two years ago, your premium is higher now. This is called Income-Related Monthly Adjustment Amount (IRMAA). If your income was very low two years ago, you pay the standard premium. If your income was above a certain threshold, you pay more — sometimes significantly more. The income thresholds and premium amounts change each year.

When your SSDI payment is small, Social Security may not be able to deduct the full Part B premium from your check. If this happens, you will receive a bill from Medicare for the amount that could not be deducted. You must pay this bill directly to avoid losing Part B coverage.

Part D: Prescription Drug Coverage (Optional)

Part D is optional coverage for prescription medications. If you do not choose a plan during your initial enrollment period, you may pay a penalty later if you sign up. The monthly premium for Part D varies depending on which plan you choose — plans range from about $5 to $100+ per month, and the cost changes yearly.

You can change your Part D plan once per year during the annual enrollment period (October 15 to December 7). If you have low income, you may be able to get help paying Part D premiums and out-of-pocket costs through the Low-Income Subsidy (LIS) program, also called "Extra Help." You can ask Social Security or Medicare whether you may have access to.

Medigap Supplemental Coverage (Optional)

Medigap plans are sold by private insurance companies and help pay costs that Medicare does not cover — like deductibles, coinsurance, and copayments. Medigap is optional. If you buy it, you pay a separate monthly premium to the insurance company on top of your Part B premium.

Medigap premiums vary widely depending on which plan you choose (plans are labeled A through N) and which insurance company sells it. A basic plan might cost $100 to $200 per month; a more comprehensive plan might cost $200 to $400 or more. You can shop for Medigap plans and compare prices, but you should do this during your initial enrollment period (the six months after you turn 65 or after you first become may be able to access for Medicare). If you wait, insurance companies can charge you more or deny you coverage based on your health.

When Your SSDI Payment Is Too Small to Cover Part B

If your monthly SSDI payment is less than your Part B premium, Social Security cannot deduct the full amount from your check. Instead, you will receive a separate bill from Medicare (the Centers for Medicare and Medicaid Services, or CMS) for the difference. You must pay this bill within the important date stated on the notice, or your Part B coverage will end.

If you receive a bill you cannot pay, contact Medicare at 1-800-MEDICARE (1-800-633-4227) to ask about payment plans or hardship exceptions. Do not ignore the bill — losing Part B coverage is difficult to reverse and will leave you without medical insurance.

How Income Affects Your Medicare Costs

Your Part B premium is based on your Modified Adjusted Gross Income (MAGI) from two years before. If you earned wages, had self-employment income, or received other income two years ago, your premium is higher now. Social Security sends you a notice each year in December showing your income and your new premium for the following year.

If your income has dropped since then — for example, you stopped working or your investment income decreased — you can ask Social Security to recalculate your premium based on your current income. You must file a form called the Medicare Income-Related Monthly Adjustment Amount — Life-Changing Event (form SSA-44). Life-changing events include job loss, divorce, death of a spouse, or a substantial drop in income or resources. Social Security will review your request and may lower your premium if you may have access to.

Frequently Asked Questions

Do I have to take Medicare when I become may be able to access on SSDI?

Yes. After 24 months on SSDI, you are enrolled in Medicare automatically. You cannot decline it. However, if you are still working and have health insurance through your job, you can ask Social Security to delay Part B enrollment to avoid paying the premium while you have other coverage. You must request this in writing before your enrollment period ends.

What happens to my Medicare if I go back to work and earn too much?

Your Medicare coverage continues even if your earnings cause your SSDI payments to stop. You keep Part A and Part B. However, your Part B premium may increase based on your new income. You will still owe the premium even if you no longer receive an SSDI check.

Can I switch from one Medicare plan to another?

You can change Part D plans once per year during open enrollment. For Medigap, you can switch plans, but insurance companies can charge you more or deny coverage if you have health problems. Part A and Part B cannot be changed — they are your basic Medicare coverage.

What if I cannot afford my Medicare costs?

If your income is very low, you may be able to get help through Medicaid (your state program, not Medicare). You can also ask about the Low-Income Subsidy for Part D, Medicare Savings Programs that help pay Part B premiums, or payment plans through Medicare. Contact your local Medicaid office or call 1-800-MEDICARE to learn what programs you may be able to use.

Will my Medicare costs go up every year?

Yes. Part B premiums increase most years. Part D premiums also change yearly. Medigap premiums depend on your insurance company and plan. Social Security sends you a notice each December showing your new Part B premium for the following year. You should review it and check whether your other coverage costs have changed.