Dear Rusty: Is there any way I can get out of paying the $185 I am told will be taken out of my Social Security for Medicare Part B when I turn 65? We pay for Medicare all our working lives, and now I have to pay a monthly premium for insurance that only covers 80 percent.

Signed: Disheartened Senior

Dear Disheartened Senior: For clarification, the money you paid into Medicare while working during your lifetime was for Medicare Part A (inpatient hospitalization coverage). The Medicare taxes paid while working entitled you to free Medicare coverage for Part A inpatient hospitalization coverage, but they do not entitle you to Medicare coverage for outpatient services (coverage for doctors, medical tests, etc.). For that coverage from Medicare, you must enroll in Medicare Part B, for which there is a monthly premium ($185 per month for 2025). If you wish to have Medicare Part B coverage, you must enroll in Medicare Part B at age 65 — unless you have other “creditable” health-care coverage from an employer.

The Medicare Part B premium will be automatically deducted from your Social Security payment when you enroll in Medicare, and there is no way to avoid it if you wish to have Medicare health-care coverage for outpatient medical services. But, if you currently have “creditable” health-care coverage from an employer, you can delay enrolling in Medicare Part B (thus avoiding the premium) until your employer coverage ends. If you don’t enroll in Medicare Part B during your initial enrollment period (at 65), or in a special enrollment period following the end of your creditable employer health-care coverage, then you will incur a penalty for enrolling in Medicare Part B outside of the prescribed enrollment periods. That penalty is a permanent increase in your Medicare Part B premium. FYI, “creditable” is an employer group plan with at least 20 participants.

We do not advise going without outpatient health-care coverage, so you should carefully consider enrolling in Medicare Part B when you turn 65. If you are already collecting Social Security benefits, you will be automatically enrolled, but you can opt out of Part B if you wish — it’s just not advisable, unless you have current creditable health-care coverage from an employer.

So, to recap: the Medicare taxes you paid while working only entitled you to free Medicare Part A inpatient hospitalization coverage. You must enroll in Medicare Part B (for which there is a monthly premium) to have Medicare health-care coverage for outpatient health-care services. Both Medicare Part A and Part B have deductibles and copayments, for which you may wish to consider getting either a supplemental insurance plan or a Medicare Advantage plan. But, in either case, you must still have both Medicare Part A and Part B to obtain such additional health-care coverage.                               

Russell Gloor is a national Social Security advisor at the AMAC Foundation, the nonprofit arm of the Association of Mature American Citizens (AMAC). The 2.4-million-member AMAC says it is a senior advocacy organization. Send your questions to: ssadvisor@amacfoundation.org.

Author’s note: This article 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). The NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity.