Most people with Medicare never write a premium check. Social Security withholds the Part B premium from the monthly benefit payment before it hits the bank, and that is the end of it.
The people who do get a bill are usually surprised by it, and the paperwork that follows is genuinely confusing: a form number nobody recognizes, a quarterly billing cycle that does not match anything else in their budget, and a warning about losing coverage. This page covers who gets billed, the four ways to pay, and exactly what the clock looks like if a payment slips. All figures were verified on September 6, 2026.
Who Actually Gets a Medicare Bill
Social Security’s rule is simple: if you are receiving monthly Social Security benefits, Medicare premiums are usually deducted automatically. If you are not, CMS mails you a bill.
That leaves three groups holding a bill:
- People enrolled in Medicare but not yet collecting Social Security. Common if you took Medicare at 65 and are delaying your benefit claim to a later age.
- People who owe a Part A premium. Part A is free for most, but if you did not earn 40 quarters of Medicare-covered employment, the 2026 Part A premium is $311 a month with 30 to 39 quarters, or $565 a month with fewer than 30, per the CMS 2026 Parts A and B premiums fact sheet.
- People who owe a Part D IRMAA. The Part D income-related monthly adjustment amount is billed by Medicare, not by your drug plan, and it appears as its own line on the bill. Part B and Part D surcharges start above $109,000 in modified adjusted gross income for individual filers and $218,000 for joint filers in 2026.
For reference, the 2026 standard Part B premium is $202.90 a month, up $17.90 from $185.00 in 2025, and the 2026 Part B deductible is $283. The Federal Register notice setting those rates, published in November 2025, states the same $202.90 figure and confirms the deductible at $283.00.
The Medicare Premium Bill (CMS-500)
The bill itself is form CMS-500. It arrives around the 10th of the month, and Medicare must receive payment by the 25th of the month for it to count as on time.
Billing frequency depends on what you owe. Part B by itself is billed every three months. A Part A premium is billed every month. A Part D IRMAA is billed every month.
The bill’s front page carries the total due, the coverage period, a breakdown by Part A, Part B, Part B IRMAA and Part D IRMAA, and a payment coupon. Two things only appear when you are behind. A “Past Premium Due” line shows up once you are at least one billing period late. A “DELINQUENT BILL” stamp and a printed coverage termination date appear only once you are 90 days past due.
One detail worth knowing before you overpay on purpose: you cannot direct how extra money is applied. CMS applies overpayments first to any past due balance, then to Part B and Part A, and last to Part D IRMAA.
The Four Ways to Pay
| Method | How you set it up | Setup time | What it costs | When it posts |
|---|---|---|---|---|
| Secure Medicare account | Log in at Medicare.gov, choose My Premiums, pay by card or bank account | Immediate | No Medicare fee | Card same day; bank account about 5 business days; posted within 3 to 5 business days |
| Medicare Easy Pay | Sign up in your Medicare account, or mail form SF-5510 | 6 to 8 weeks | Free | Debited on the 20th of each month, or the next business day |
| Your bank’s online bill pay | Enroll through your bank using the payee details Medicare publishes | Varies by bank | Bank may charge a fee | Depends on your bank |
| Return the payment coupon with a check, money order, or signed card details | Immediate | Postage, plus card or money order costs | Must arrive by the 25th; allow mail time |
Medicare calls the online account the quickest way to pay. Phone payments are not accepted at all. If you mail a payment, send one coupon and one payment per envelope, write your Medicare number on the check, and skip the cover letter, because notes on the coupon delay processing.
The mailing address for a payment is the Medicare Premium Collection Center, PO Box 790355, St. Louis, MO 63179-0355.
Setting Up Medicare Easy Pay
Easy Pay is a recurring ACH debit from a checking or savings account. It is free, the amount adjusts automatically when your premium changes, and it shows up on your bank statement as a CMS Medicare Premium ACH transaction.
There are two ways in. Online, log into your Medicare account, select My Premiums, then Sign Up, and fill out the short form. On paper, complete form SF-5510, the Authorization Agreement for Preauthorized Payments, available in English and Spanish from CMS, and mail the signed original to the Centers for Medicare & Medicaid Services, Medicare Premium Collection Center, PO Box 979098, St. Louis, MO 63197-9000. Have your Medicare card and a blank check in front of you when you fill it out.
Then wait. CMS says processing can take 6 to 8 weeks, and you must keep paying by another method in the meantime or you will fall behind while the enrollment is pending. Your first automatic deduction can cover up to three months of premiums at once if a balance has built up. After that, each deduction is limited to one month’s premium plus $10.
Use the same SF-5510 to change your bank account (another 6 to 8 weeks) or to stop Easy Pay (up to 4 weeks). Both changes can also be made online under My Premiums.
What Happens If You Miss a Payment
Nothing dramatic happens on day 26. The unpaid amount rolls onto your next bill as “Past Premium Due” and you keep your coverage.
The consequential clock is 90 days. Section 1838(b) of the Social Security Act provides that Part B coverage terminates for nonpayment of premiums, and Social Security’s operating manual sets the initial grace period at 90 days. Once you are 90 days past due, your CMS-500 arrives stamped DELINQUENT BILL and prints an actual coverage termination date next to Part A and Part B. If the total due is not paid in full by that date, coverage ends.
Social Security may extend the grace period by another 90 days, for a maximum of 180, when there is good cause for the failure to pay. In practice there is also a buffer at the end: termination notices are generally not sent until roughly 30 days after the grace period closes, because payments received late in the period cannot always be processed in time, and receipt of everything due during that window reverses the termination.
Losing coverage this way is expensive twice over. You still owe every dollar of the unpaid premiums, and CMS warns that reapplying later can mean waiting for an enrollment window, a higher Part A premium, and a lifetime late enrollment penalty on Part B and Part D.
Getting Reinstated After Termination
Reinstatement is possible, and the deadline is short.
If you did not know the premiums were due or unpaid, Social Security can treat them as paid on time. You have to ask for relief by the end of the month following the month you receive an effective termination notice, and pay all premiums due through the month of the request within 30 days of making it. Coverage is not restored until that payment clears.
Social Security’s manual gives two situations where this is normally granted: your billing notice was misaddressed or lost so you did not receive it at least 30 days before the grace period ended, or you were told by SSA or CMS staff that the premiums would be paid by someone else, such as a state agency or a group payer.
There is a hard limit. Relief cannot be granted to someone who got timely notice and simply could not afford to pay, other than through the 90-day good cause extension, and it cannot be granted at all if requested more than one month after the month you received the termination notice. Call Social Security at 1-800-772-1213, not Medicare, since Social Security handles enrollment and reinstatement.
Programs That Pay the Premium For You
If the premium itself is the problem, the fix is not a payment method. It is a program that takes the premium off your plate entirely.
Medicare Savings Programs are state-run and can pay your Part B premium outright, which for 2026 is $202.90 a month, or $2,434.80 a year. Some levels also cover the Part A premium, deductibles and coinsurance. Extra Help does the equivalent job on the drug side, and it is worth checking before you consider the Medicare Prescription Payment Plan, which only reschedules drug costs rather than reducing them.
If your bill is inflated by an income surcharge based on a tax year that no longer reflects your income, the IRMAA appeal process exists for exactly that.
And if the pressure is coming from the provider side rather than the premium side, that is a different playbook: medical bill assistance programs and negotiating the bill directly.
The Bottom Line
Easy Pay is the right default if you receive a Medicare bill and want to stop thinking about it, as long as you start it 6 to 8 weeks before you need it and keep paying manually until the first debit lands. Paying through your Medicare account is the better tool for a one-off catch-up payment, because it posts in days rather than weeks.
Whichever method you pick, the date that matters is the 25th, and the number that matters is 90 days. Past that, the bill stops being a bill and starts being a termination notice.