A person enrolled in Medicare gets regular bills for their premiums, depending on their coverage and benefits. A person can pay their premiums in several ways.
This article looks at when and how to pay for the Medicare premium. It also examines premium costs and help with paying the premiums.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare is a federal program, which has several parts.
- Part A provides coverage for hospital services.
- Part B is medical insurance.
- Part C, also called Medicare Advantage, is offered by private companies and is an alternative to original Medicare parts A and B.
- Part D is prescription drug coverage.
All Medicare bills are due on the 25th day of the month. Usually, the premium payment is due the same month in which a person gets the bill. For example, if a person gets the bill in early May, payment is due on May 25.
Most people get Medicare Part A at no cost. However, if a person has to pay for Part A, they will get a Medicare premium bill CMS-500 every month.
If a person gets benefits, the premium for Part B is automatically deducted. However, if a person has enrolled in Part B and pays the premium, they will get a Medicare premium bill CMS-500 every 3 months.
Part C, also known as Medicare Advantage, provides alternative coverage for original Medicare. A person enrolled in Part C will pay a premium to the private company offering the Advantage plan. The premium amount depends on the type of plan and coverage.
Depending on their income, a person may have to pay Part D IRMAA. In that case, they will get a Medicare premium bill CMS-500 every month.
If a person has questions about their bill, they can call the Social Security Administration at 1-800-772-1213 (TTY: 1-800-325-0778).
There are several ways to pay Medicare premiums.
- Pay online: A person can pay online through their secure Medicare account. Payment can be done through a credit card, debit card, or a checking or savings account.
- Paying through a bank: A person can pay their bill directly from a savings or checking account via the bank online bill payment service.
- Sign up for Medicare Easy Pay: Medicare Easy Pay is a free service that automatically deducts payments directly from a person’s checking or savings account. The amounts are usually taken from the account on the 20th day of the month.
- Pay by mail: A person can mail their payment directly to Medicare. A payment coupon is sent with the bill for the premiums, and it needs to be filled in with the correct payment details, and then signed. If a person sends the payment without completing and enclosing the coupon, the payments may be delayed.
If a person gets Social Security or Railroad Retirement Board (RRB) benefits and has Part B (medical insurance), the premium will be deducted from their monthly benefit payment.
Medicare issues several notices of late payment. Eventually, if the bill is not paid, a person may lose their Medicare coverage.
The late payment notices are sent out in the following order:
- If a person misses the due date for paying their first bill, they will receive a second bill.
- The second bill will include the current amount due and also the amount due for the next premium payment owed.
- If a person fails to pay the total amount due by the 25th of that month, they will receive a delinquent bill.
- If a person then fails to pay the delinquent bill by the 25th of that month, they will lose their Medicare coverage.
Losing coverage notice
The Medicare premium bill will show a person if they are at risk of losing healthcare coverage.
|Information in box in right-hand corner||Meaning||Action needed|
|This is not a bill||A person has Medicare Easy Pay.||None|
|First bill||A person has paid the previous bill, and this is their next bill.||Payment needs to be sent in by the due date.|
|Second bill||A person is late by at least 60 days in paying the previous bill.||Payment needs to be sent in by the due date.|
|Delinquent bill||A person has not paid the previous bill, which is now at least 90 days late.||Payment must be sent in by the due date or a person may lose coverage.|
A person can call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778) if they have questions about their bill.
There are several ways a person may get financial assistance to pay Medicare premiums.
For example, a person may qualify for extra help from Medicare to pay the costs of prescription drug coverage (Part D). They will need to meet set income and resource limits.
In addition, Supplemental Security Income (SSI) is a monthly benefit for people with limited income or resources, who have disabilities, including blindness, or are aged 65 or older. SSI benefits are separate from Social Security retirement or disability benefits.
Other available help includes the following:
- Medicaid is a partnered federal/state program. It may help with health costs for some individuals with limited income.
- Medicare savings programs may help a person pay the premiums. These programs may also help with coinsurance, copays, deductibles, and prescription drug costs.
- TheProgram of All-inclusive Care for the Elderly (PACE) helps local communities meet social and medical needs. Many people who get PACE may also be eligible for Medicaid and Medicare.
- Extra Help is a program that helps a person with limited income and resources to pay Medicare prescription drug costs, such as deductibles, coinsurance, and premiums. If a person gets Extra Help but is not sure if they are paying the correct amount, their drug plan can help verify the correct level.
- The Children’s Health Insurance Program (CHIP) provides free or low-cost health coverage for children under the age of 20. CHIP covers United States citizens and eligible immigrants.
There are also programs for people with limited income and resources, living in five U.S. territories, including Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, and American Samoa.
Medicare recipients usually get a Medicare bill either monthly or quarterly, depending on their plan coverage.
There are several ways a person can pay their premiums. They may also qualify for additional assistance in paying the bills.
A person should keep track of their Medicare bills and pay them promptly. A delinquent bill could lead to a person losing their Medicare coverage.