Medicare premium vs. small Social Security benefit confusion - WEP impact on billing

This is actually a common situation with WEP-affected benefits that are smaller than the Medicare premium. The SSA-1099 for 2025 only shows the direct payment you received ($182) because that was paid directly to you. The ongoing Medicare premium payments aren't reflected on the 1099 because those payments are essentially "invisible" to you - SSA sends that money directly to Medicare. Medicare should be sending you quarterly bills for the difference between your SS benefit and the full premium amount. For example, if your premium is $240/month and your benefit is $182/month, Medicare should bill you quarterly for the $58/month difference (about $174 per quarter). If you're not receiving these quarterly bills from Medicare, that's where the problem lies. Have you checked your Medicare account online?

MY HUSBAND HAD EXACT SAME ISSUE!!! It's ridiculous how they handle these WEP situations. We called Medicare EIGHT TIMES and SS ELEVEN TIMES last year to straighten this out. Turns out neither office knew what the other was doing!!! Medicare kept saying SS was handling everything, SS said Medicare should be billing us quarterly. After months of frustration, we finally got a letter from Medicare saying we owed $783 in unpaid premiums!!! No warning, no previous bills, NOTHING! Check your mailbox carefully - you might get hit with a big bill like we did. The system is BROKEN for people with small SS checks.

As someone who worked at SSA for 15 years, I can clarify this situation. When your SS benefit is less than your Medicare premium, the process works like this: 1. SSA applies your entire monthly benefit toward your Medicare premium 2. CMS (Medicare) bills you quarterly for the remainder 3. Your SSA-1099 will only show actual payments made to you, not the premium payments transferred to Medicare The most likely issue is that CMS hasn't properly set up the quarterly billing. This happens about 10-15% of the time with WEP-affected beneficiaries because the systems don't communicate perfectly. You need to contact Medicare directly at 1-800-MEDICARE and specifically ask about your "Medicare Premium Bill" (CMS-500) status. Tell them you have a partial premium withholding from a reduced Social Security benefit and need to verify your billing status. Don't panic - they can't charge penalties if they failed to bill you properly. This is fixable, but you do need to be proactive.

had similar issue last yr. called ss 6 times never got anwsers. Medicare sent huge bill in December all at once! wish they would just explain this stuff better when u sign up.

I went through this exact nightmare last year trying to figure out my Medicare billing with a small Social Security check affected by WEP. After MONTHS of trying to reach someone at Social Security (endless busy signals, disconnections, and 2+ hour hold times), I finally discovered Claimyr.com - it's a service that gets you through to a live SSA agent usually within 20 minutes instead of waiting for hours or getting disconnected. They have a video showing how it works here: https://youtu.be/Z-BRbJw3puU It saved my sanity. I finally got through to SSA who confirmed exactly what was happening with my Medicare premium situation and fixed a mistake in their system that was causing Medicare not to bill me properly. Completely worth it after wasting weeks trying to get through on my own.

Jumping in to say Medicare & Social Security confusion is the most frustrating thing ever. My retirement benefit is $876 so I don't have the same issue as you, but I've spent countless hours trying to understand how all this works. Phones are useless these days - I physically went to my SSA office last month after weeks of failed calls.

To follow up on my earlier comment, this is definitely a case where getting confirmation in writing is important. After you speak with Medicare about the quarterly billing, request written confirmation of: 1. The exact amount of your Medicare premium 2. The exact amount being paid from your Social Security benefit 3. The exact amount you'll be billed quarterly 4. When those quarterly bills will be sent Also ask them to document in your account that you've been proactively trying to resolve this billing issue. This creates a record showing you've been attempting to address it, which can help if there are any questions later about why payments weren't made. The WEP complication makes these cases trickier because the systems are primarily designed for people whose benefits fully cover their Medicare premiums or who don't receive Social Security at all.

Just a warning - when we FINALLY got our Medicare billing straightened out, they gave us only 30 DAYS to pay the entire past-due amount!!! We had to dip into our emergency savings. Make sure you ask about payment plans IMMEDIATELY if they say you owe back payments! Don't let them tell you "we'll send information in the mail" because sometimes that info comes AFTER the due date!!!

my wifes on medicare and we get so confused with all the paperwork they send. ss and medicare need to get there systems working together better