Why Social Security Isn't Paying for Medicare Part B Anymore

Many people who rely on Social Security for their monthly income are confused - and worried - when they notice their Medicare Part B premium is no longer being taken out of their Social Security check. It’s not a mistake. It’s not a glitch. And it’s not because the government stopped paying for it. The truth is more complicated, and it’s tied to changes in income, enrollment rules, and how Medicare premiums are collected.

What Medicare Part B Actually Covers

Medicare Part B isn’t about hospital stays - that’s Part A. Part B covers doctor visits, outpatient care, preventive services, lab tests, and most importantly, many prescription drugs you get at the doctor’s office or through durable medical equipment. It also pays for things like diabetes supplies, mental health counseling, and ambulance services. In 2026, the standard monthly premium for Part B is $174.70. That’s up from $164.90 in 2025, and it’s been rising steadily for years.

For most people, this premium is automatically deducted from their monthly Social Security benefit. That’s convenient. It means you don’t have to write a check, track a due date, or risk a late payment that could cancel your coverage. But here’s the catch: Social Security doesn’t pay your Medicare premium. It just collects it on behalf of Medicare. And if you’re not getting Social Security, or if something changes in your situation, that automatic deduction stops.

Why the Deduction Might Have Stopped

If your Medicare Part B premium is no longer being taken from your Social Security check, one of these five things likely happened:

1. You started receiving Social Security benefits for the first time, but you didn’t enroll in Medicare Part B at the same time.
2. You’re new to Medicare and signed up directly through Social Security - but your benefits haven’t started yet.
3. Your Social Security payment was reduced or stopped due to an overpayment, garnishment, or other adjustment.
4. You’re enrolled in Medicare Part B, but you’re not receiving Social Security retirement or disability payments.
5. Your income went above the threshold for the Income-Related Monthly Adjustment Amount (IRMAA), and you’re now billed directly.

Let’s break down the most common reason: you’re not receiving Social Security benefits. If you’re 65 or older and you’re eligible for Medicare but you haven’t claimed Social Security yet - maybe you’re still working, or you delayed claiming to get higher payments later - then Medicare won’t automatically take the premium from your Social Security check. Because there isn’t one.

In that case, you’ll get a bill from Medicare. It usually arrives in the mail every three months. If you ignore it, your coverage could be canceled. And once it’s canceled, getting it back isn’t easy. You’ll face a late enrollment penalty that adds 10% to your premium for each full 12-month period you could’ve had Part B but didn’t sign up.

What Happens When Your Income Rises

Medicare doesn’t charge everyone the same premium. If your income is above a certain level, you pay more. For 2026, if you file taxes as an individual and your modified adjusted gross income (MAGI) is over $106,000, or $212,000 for a married couple filing jointly, you pay extra. That’s called IRMAA.

Here’s how it works: If your income last year (based on your 2024 tax return, which Medicare uses for 2026 premiums) put you above the limit, Medicare stops deducting your premium from Social Security. Instead, they send you a separate bill - often for $250, $350, or even more per month - depending on how high your income is.

People often don’t realize this is happening until they look at their bank statement and see a Medicare bill they weren’t expecting. They assume something’s wrong. But it’s not. It’s just the system working as designed. If your income dropped this year because you retired, sold a business, or had a major life change, you can file a form with Social Security to get your premium lowered. But you have to ask.

What You Should Do Right Now

If you’ve noticed your Medicare Part B premium is no longer being deducted from your Social Security check, here’s what to do immediately:

1. Check your mail. Look for a letter from Medicare titled “Medicare Premium Bill.” It will explain why you’re being billed directly.
2. Log into your Medicare.gov account. You can see your premium status, payment history, and any notices there.
3. Call 1-800-MEDICARE (1-800-633-4227). Ask: “Why is my Part B premium no longer being deducted from my Social Security?” They’ll tell you exactly why and what your options are.
4. If you’re being billed directly and you can’t afford it, ask about the Medicare Savings Program. It can help low-income people pay their premiums, deductibles, and coinsurance.

Don’t wait. Even if you think you’ll pay it later, missing a payment can lead to a coverage gap. And once your coverage lapses, you could be stuck paying penalties for months or years.

Who Still Gets the Deduction?

If you’re still getting your Part B premium taken out of your Social Security check, you’re in the majority. About 70% of Medicare beneficiaries get their premium automatically deducted. That includes:

• People who started Social Security before age 65 and were automatically enrolled in Medicare
• People who claimed Social Security at 65 and signed up for Part B at the same time
• People with low or moderate income who don’t pay IRMAA
• Disabled workers under 65 who receive Social Security Disability Insurance (SSDI) and have been on it for 24 months

If you’re one of them, great. But don’t assume it’ll stay that way forever. If your income changes, if you stop getting Social Security, or if you move overseas, the automatic deduction can stop. Always keep an eye on your mail and your Medicare account.

What About Prescription Costs?

Medicare Part B doesn’t cover most drugs you pick up at the pharmacy - those are covered by Part D. But it does cover some important ones: chemotherapy drugs given in a clinic, certain injectables like insulin pens, and drugs used with durable medical equipment like nebulizers. If you’re paying more out-of-pocket for these, it’s not because Part B disappeared. It’s because your Part D plan changed, your drug moved to a higher tier, or your pharmacy switched.

Part B premiums and prescription costs are two separate issues. But they’re often confused. If you’re struggling with medication costs, look into the Extra Help program (Low-Income Subsidy) for Part D. It can reduce your monthly premiums, deductibles, and copays - sometimes to zero. You don’t need to be on Medicaid to qualify.

What to Do If You’re Overwhelmed

If this feels like a maze, you’re not alone. Millions of seniors face this every year. The good news? Help is free.

Call your State Health Insurance Assistance Program (SHIP). Every state has one. They offer free, personalized counseling. They can help you understand your bill, apply for savings programs, or even appeal a decision. Find yours at shiptacenter.org.

You can also contact your local Area Agency on Aging. They often have staff who specialize in Medicare issues and can walk you through your options.

Don’t let confusion lead to lost coverage. Medicare Part B hasn’t been canceled. It’s still there. You’re still covered. You just need to know how you’re paying for it now - and what to do next.