Just like Part B, you can have your Medicare Part D premiums deducted from your Social Security benefit.
Even though you get Medicare Part D prescription drug coverage from a stand-alone drug plan or through a Medicare Advantage (Part C) plan, not Original Medicare, you can still have the drug plan’s premium withheld from your Social Security payment. This deduction is called premium withhold.
Most Part D drug plans charge a monthly premium, though this varies by plan and can change from year to year. (Or, the monthly premium for a Medicare Advantage [MA] or Medicare Cost Plan may include the Part D premium.) You must pay this premium in addition to your Part B monthly premium every month.
Even though you can ask for your drug plan’s premium to be withheld, it may work differently in different situations, and there are a few important things to keep in mind.
How to Get Medicare Part D Deducted from Social Security
Your Medicare Part D premium is not automatically deducted from Social Security.
To get this withhold set up, contact your Part D drug plan and ask to get your monthly premium deducted from your monthly Social Security or Railroad Retirement Board (RRB) payment. Do not contact Social Security or the RRB as they cannot help you get this set up.
Your plan will ask for the information they need to get these deductions set up. There is nothing additional that you need to do.
Or, you may have the option to select automatic deductions of your monthly premium when you enroll in your new Part D plan.
What if I Get a Denial Letter?
Some people may receive a letter from the Social Security Administration (SSA) stating it will not deduct money for your Medicare prescription drug plan from your monthly benefits. This may be because the plan did not have enough time to organize automatic premium deduction from your Social Security check, resulting in a delay or denial of deductions.
If this happens, contact your plan again after the start of your coverage and ask to change how your premiums are paid, and you may be able to again choose automatic withhold from Social Security.
Either way, you must still pay your bill, or you could be involuntarily disenrolled from your Medicare plan. If this happens, you will likely not be able to show “good cause” for reinstatement back in the plan.
Can I Get Other Medicare Monthly Premiums Withheld from Social Security?
If you are signed up for both Social Security and Medicare Part B (medical insurance), the SSA will automatically deduct the Part B premium from your monthly benefit. You do not have to do anything to enroll in the automatic deduction.
If you are enrolled in Part B but not collecting Social Security, you’ll be billed quarterly by Medicare and must pay electronically or by mail.
How Long Does it Take for Part D Premiums to be Withheld?
Be prepared for it to take up to three months from the time you request your premium be withheld before you start seeing the premiums withheld from your Social Security payment. In the meantime, you’ll receive a bill from your drug plan, and you will have to pay the premiums by check or electronic funds transfer.
The timing depends on when the plan gets your enrollment request. For example, if you enroll immediately during the Annual Open Enrollment Period, the request may be processed in time where premiums will be withheld from the start of your enrollment in the plan.
In cases where you didn’t withhold premiums for one or two months after you enrolled in a Part D plan, or you enroll late in the Annual Open Enrollment period, you’ll get a bill for the months your drug plan’s premiums aren't withheld and you’d have to pay those premiums directly to your drug plan.
Your drug plan will also let you know if there are any issues withholding premiums from your Social Security payment.
What Happens if I Switch to Another Drug Plan?
If your premiums are being withheld from one drug plan, you can still get your premiums withheld from your new plan instead. However, the timing of this depends on how early in the Open Enrollment Period you enroll in your new plan.
In some cases, the withholding for your new plan will begin in January. In other cases, you may be asked to pay your new drug plan premiums each month until premium withholding is set up. You would receive a bill from your drug plan telling you how much you owe and how to make the payment.
It’s important to note that you may have to follow up with your plan and contact them again to let them know you want your monthly premiums withheld. Pay attention to all mailings and billings you receive from your new drug plan, and they will let you know when the withhold is set up and complete.
Or, you can choose to not have your payments withheld from Social Security at all. In this case, you should begin receiving bills from your new drug plan. However, sometimes your premium withhold may continue through January or February (depending on when you switch plans). Social Security will refund any payments that are withheld.
How Much Does Part D Cost?
Exact premiums and costs may vary by plan. While most people will only pay their monthly Part D premium and applicable copayments, you may also have to pay a late enrollment penalty if you don’t sign up for Part D when you’re first eligible.
Part D Late Enrollment Penalty
If you do not enroll in Part D on time, you may owe a late enrollment penalty. This includes if you enroll after your Initial Enrollment Period is over, or if there’s a period of 63 or more days in a row when you don’t have prescription drug coverage. You will be required to pay this penalty for as long as you have Medicare drug coverage.
Medicare calculates the penalty by multiplying 1% of the “national base beneficiary premium” times the number of full, uncovered months you didn’t have Part D coverage. In 2023 it is $32.74. Premiums are rounded to the nearest $0.10.
For example, if you go for 12 months without prescription drug coverage, your penalty will be 12% (1% per month) of $32.74, or $3.9288. Rounding to the nearest $0.10, you will pay an additional $3.90 on your plan’s monthly premium.
When you join a Medicare drug plan, the plan will let you know if you owe a penalty and what your premium will be. As long as you have a drug plan, you will not have to pay the penalty.
What Is Part D-IRMAA?
If you are what Medicare calls a high earner, (a modified adjusted gross income of $97,000 or more if you file individually or $194,000 or more if you’re married and file jointly), you’ll have to pay the Medicare Income-Related Monthly Adjustment Amount, or IRMAA. You’ll have to pay this whether you’re in a stand-alone drug plan, or enrolled in a MA plan.
Social Security will let you know if you have to pay Part D-IRMAA based on your income. This can change from year to year.
Note that this isn’t part of your plan’s premium, and you wouldn’t pay this to your plan. Most people have it removed from their Social Security check, or you’ll receive a bill from Medicare or the RRB.
If your filing status and yearly joining income in 2020 falls under one of the following, see how much you’ll pay each month in 2023.
What Is Extra Help?
If you qualify, you may be able to get extra help paying Part D monthly premiums, annual deductibles, and copays. However, you must be enrolled in a Medicare prescription drug plan to get this help.
To qualify, you must be receiving Medicare, have limited resources and income, and reside in one of the 50 states. You must provide your plan with information to help them check if you should receive Extra Help and at what level.
If you qualify, you’ll pay no more than $3.95 for generic drugs and $9.85 for brand-name covered drugs (in 2023).
When to Apply for Medicare
There are a few times per year when you can sign up for either a Medicare drug plan (Part D) or Medicare Advantage plan (Part C). During these times, you can also make changes to your existing coverage.
Initial Enrollment Period
- When you’re newly eligible for Medicare because you just turned 65, you’re able to enroll in the three months before the month you turn 65, the month you turn 65, and the three months after you turn 65.
- When you’re newly eligible for Medicare because you have a disability, you’re able to enroll 24 months after you get your Social Security or Railroad Retirement Board (RRB) benefits. Your enrollment period is the three months before your 25th month of receiving benefits, the 25th month of getting disability benefits, and the three months after the 25th month of getting disability benefits.
- If you’re already eligible for Medicare due to a disability and turn 65, you’re able to sign up for an MA plan or Part D plan, switch from your current plan to another, or drop an MA plan or drug coverage completely. You can do this in the three months before the month you turn 65, the month you turn 65, and the three months after you turn 65.
Special Enrollment Period
You’re able to make changes to either your MA plan or Part D converge if certain events happen in your life, such as moving or gaining/losing other insurance coverage. This time is called a Special Enrollment Period (SEP).
Depending on your situation, you can switch, change or drop MA or Part D coverage. Contact Medicare or the plan to learn if your situation qualifies for an SEP, but some examples may include (but are not limited to):
- If you moved to a new address that isn’t in your plan’s service area.
- You moved back into the U.S. after living outside the country.
- You left coverage from your employer or union.
- Medicare terminates your plan’s contract.
- You qualify for Extra Help.
- You’re eligible for both Medicare and Medicaid.
Other Enrollment Periods
- Annual Enrollment Period for Medicare Advantage and Medicare prescription drug coverage takes place from October 15 through December 7. During this time, you can make a number of changes in your Medicare coverage including enrolling in a Medicare Advantage plan or Part D plan, switching from one plan to another, or dropping coverage.
- Medicare Advantage Open Enrollment Period takes place from January 1 through March 31. During this time, you can switch from one MA plan to another (with or without drug coverage) or drop your MA plan and return to Original Medicare. You’ll also be able to join a Part D plan.
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