Question: I’m getting ready to sign up for Medicare, but I don’t want to collect Social Security yet. How will I pay for the Medicare Part B premium?

Answer: Social Security and Medicare have been around a long time, and for many of those years, individuals filed for both benefits at the same time. Now many individuals wait to collect their Social Security Benefit until after they sign up for Medicare Part A & B.

To understand this trend, I’ll lay out the timing: while you MAY start collecting Social Security as early as age 62, individuals born after 1960 don’t reach “full retirement age” (FRA) until their 67th birthday. So many newly-eligible individuals opt to wait until FRA to collect Social Security. However, Medicare eligibility for most individuals starts when they turn 65. So, along the way to FRA, they’ll still need to make a Medicare enrollment decision at age 65.

To address your situation, let’s start by contrasting it with individuals that DO collect Social Security before they become Medicare eligible: First, they’ll be automatically enrolled into Medicare Parts A & B starting the month in which they turn 65. Second, before they even turn 65, they will be mailed a Medicare ID card with their ID number and their Part A & B start date. Third, their Medicare Part B premium of $185/ month is automatically deducted from their Social Security Benefit. You’ll notice that all of this happens automatically, so generally the Medicare sign-up process isn’t as complicated when already collecting Social Security.

So back to your situation, where you are NOT collecting Social Security but you ARE Medicare eligible. I’ll point out that you will NOT be automatically enrolled in Medicare Part A or B, so you’ll need to take certain steps to actively enroll in the parts of Medicare you need. Once you add Part B, you will need to pay a premium to keep it active, and again it will NOT be an automatic deduction. You pay your Part B Premium using a quarterly bill that you’ll receive, known as the CMS-500.

The normal quarterly bill amount will be for $555 – the normal $185 Part B Premium, times 3 months. Sometimes the bill that individuals receive is higher than $555. This can be for three reasons: first, your quarterly bill is determined by when your birthday month falls, so you may be billed for four months instead of three ($185 X 4= $740). This would only happen on your first bill, to get you on the normal quarterly billing schedule.

The second reason you might be billed more would be that your income is high according to the IRS. This higher Medicare Part B premium is called an IRMAA (Income Related Monthly Adjustment Amount) and is based on your income on your tax returns two years prior to adding Medicare – the 2025 IRMAA is based on your 2023 tax returns. With an IRMAA, your Medicare Part B premium could be between $259 or $628.90 per month. And because you’d have a higher monthly premium, your quarterly bill will be higher to reflect this. Keep in mind that if you feel your income has reduced and you no longer believe you owe an IRMAA or it should be reduced, then you can request a reconsideration of your IRMAA from your local Social Security Administration office. This can be based on more recent tax returns, or a Life Changing Event. Examples of a Life Changing Event could be retirement, death of a spouse, remarriage, and others.

The third reason your bill might be high is that you enrolled in Medicare Part B late, after you first became eligible, and you have a Late Enrollment Penalty (LEP). An LEP is based on the number of months you were late with your enrollment. It increases your monthly Part B premium by 10% for each full, consecutive 12-month period you were late for your enrollment.

Returning to how to pay your Part B Premium, you can send a check each quarter. You can use your Part B premium bill to set up an automatic payment, like an Electronic Funds Transfer (EFT) or auto-pay with a credit card. You can also use your secure MyMedicare.gov account to pay this bill via credit card or debit card.

If/when you decide to start collecting Social Security, your Part B premium WILL automatically begin to get deducted from your monthly Benefit. At that point, you’ll stop getting a bill. Still note that the premium will be taken out of your Social Security BEFORE it is deposited into your account.

I’ll stress that you should NOT pay your Medicare Part B Premium bill late. The amount is certainly high, but it covers a three-month period, so it is less frequent than a monthly bill. Remember that you can find lots of information about this bill and other Medicare topics on the www.Medicare.gov website.

Janell Sluga is a Geriatric Care Manager helping seniors in our community access services and insurance. To reach her, please email editorial@post-journal.com.