Q & A
Ask Rusty – I’m a Retired Veteran; Why must I pay for Medicare?
Dear Rusty: I’m a retired Navy veteran who is going to be turning 65 years old this year. My question is concerning mandatory Medicare sign-up requirements. Why do I have to sign up for Medicare coverage at 65 when I can’t start collecting full Social Security benefits until I turn 67? My Social Security benefits will not pay for my mandatory Medicare because I can’t start collecting full Social Security benefits until I’m 67!
I currently pay for Tricare and utilize my local Veterans Administration medical facilities and referrals for my healthcare. With me turning 65 and having to wait until I’m 67 for my full Social Security benefits, it just seems unfair that I’ll have to pay out of pocket Medicare monthly expenses for two years! Is there any way to avoid this unfair penalty? Signed: Retired Navy Vet
Dear Retired Navy Vet: First, I want to thank you for your military service to our country. Please know that here at the AMAC Foundation we care a lot about our veterans, and you may find the “For Veterans” section of our Foundation website interesting (www.amacfoundation.org).
Regarding your question, you should be aware that enrolling in Medicare is not mandatory, but there are consequences if you do not enroll when you become eligible (normally at age 65). For one thing, if you are a retired veteran on military TriCare, you will lose your TriCare benefits if you don’t enroll in Medicare when you are eligible (TriCare requires that you enroll in Medicare when eligible). And, since you are not yet collecting Social Security, you will be required to separately pay the Medicare Part B premium directly to Medicare (they will bill you when you enroll in Medicare). Another potential consequence is that if you do not enroll in Medicare Part B when you are first eligible, you may incur a lifetime late enrollment penalty for enrolling in Part B later.
Something else to keep in mind is that there are two “parts” to Medicare – Part A (which is coverage for inpatient hospitalization services), and Part B, which is coverage for outpatient healthcare services (doctors, medical tests, etc.). Medicare Part A is free to you, but there is a premium for Medicare Part B ($185/month for 2025). Note that you will need to pay a Part B premium as long as you are enrolled in Medicare Part B (it doesn’t go away after you are collecting Social Security, but it is taken from your Social Security payment). And there is no way for you to avoid the Part B premium after enrolling, and enrolling in Part B is necessary for you to continue your military TriCare-for-life benefits. Note that Medicare Part A and Part B do not include prescription drug coverage, but your TriCare coverage usually does.
It’s important to note that Medicare and Social Security are two independent senior programs with different eligibility rules. As you may know, you can collect early (reduced) Social Security at age 65 (and have your Medicare Part B premium deducted from your SS payment). But you would be collecting Social Security early and, in addition to a reduced benefit, you would also be subject to Social Security’s annual earnings test if you are still working. The SS earnings test limits how much you can earn before some of your SS benefits are taken away (if you exceed the earnings limit prior to your full retirement age).
So, is it unfair that you must pay for Medicare Part B before you are collecting Social Security? Well, I think not, because the two programs are completely independent benefits (the Social Security Administration merely administers Medicare payments as a convenience). Remember your Medicare Part A is free, but you must pay a premium for Part B, and you must take both to retain your military TriCare-for-Life benefits. You can visit this site to see how to pay your Medicare premiums until it is later deducted from your Social Security payment: www.medicare.gov/basics/costs/pay-premiums/online-bill-pay
Once again, thank you for your service to our country.
Rusty, I do not believe you fully answered the question. I am (also) currently fully retired from the USN. I have, as promised, as part of a full career in the military, health care coverage. It is through Tricare Prime. At age 65 I am forced to give up my coverage with Tricare Prime and pay for Medicare. The Medicare supplemental insurance is then covered by “Tricare for Life.” It seems unfair to force me to give up Tricare Prime just to pay for Medicare. What say you?
Hi Rich, and thank you for your service.
I believe your issue is with the Government’s Office of Personnel Management (OPM), which has jurisdiction over federal retirement plans and retiree benefits. TriCare Prime is a managed care program for those who are not yet eligible for Medicare. TriCare Prime acts as the “Primary Payor” of your healthcare costs until you become eligible for Medicare, which takes over as Primary Payor for your healthcare, with Tricare for Life acting as “secondary payor” for those costs. Whether that is “unfair” is obviously a matter of opinion, as ALL seniors (over 65) who wish to have healthcare coverage must use Medicare as their primary coverage (unless they work for an employer who provides “creditable” coverage as an alternative to Medicare). While there is no question that you have, by virtue of your service to our country, earned special status (and my undying respect for your service), the federal government’s apparent position is that you, like all other American seniors, must enroll in Medicare when you turn 65 (to maintain your TriCare for Life healthcare benefits). In that sense, your TriCare for Life coverage acts as a supplemental insurance plan to pay for the healthcare expenses which Medicare does not cover. And that is similar to how it works for all others over 65, who must pay separately for both their primary Medicare coverage as well as any secondary supplemental healthcare coverage they choose to have.
Rich, once again, I want to thank you for your service to our country, and for your feedback on my recent article.
Regards,
Russell Gloor
Certified Social Security Advisor
The AMAC Foundation
The above is intended for information purposes only and does not represent legal or financial guidance. It presents the opinions and interpretations of the AMAC Foundation’s staff, trained and accredited by the National Social Security Association (NSSA). NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity. To submit a question, visit our website (amacfoundation.org/programs/social-security-advisory) or email us at ssadvisor@amacfoundation.org