The short answer
Most people have Medicare premiums deducted automatically from their Social Security payment. Everyone else gets the Medicare Premium Bill and can pay 4 ways: online through their Medicare account, by Medicare Easy Pay, through their bank's bill pay service, or by mail with the payment coupon. Every bill is due the 25th.
You signed up in February, your coverage started on the first, and now a bill from Medicare is on the table asking for more than one premium. Nothing has gone wrong. Medicare itself says most people never get this bill at all, which is exactly why the first one reads like a mistake.
How do I pay Medicare premiums?
Most people never pay Medicare directly, because the Part B premium is deducted automatically from their Social Security or Railroad Retirement Board benefit payment. If you do not get either benefit, Medicare sends you a premium bill instead, and there are 4 ways to pay it.
That split decides everything else on this page. Either the premium leaves your benefit before you see it, or a bill called the Medicare Premium Bill reaches you and the paying is yours to do.
The bill goes to people who pay Medicare directly for a Part A premium, a Part B premium, or a Part D income related monthly adjustment amount. Medicare states that most people never get this bill at all, because the deduction handles it.
So the first question is not which payment method to use. It is which of the two groups you are in, and the rest of this page walks the second group through the machinery.
Is it deducted from Social Security?
Yes, if you are getting benefits. Medicare deducts the Part B premium automatically from your Social Security or Railroad Retirement Board payment, and you do not have to set that up. The deduction happens on its own, as long as the benefit covers the premium amount.
The deduction is the default rather than a program you join. Medicare's page describes it as automatic for people getting benefits, and reserves the bill for everyone else.
Federal retirees who are not getting Social Security have a version of the same convenience. Medicare says you can contact your local Social Security office and have Part B premiums deducted from your Office of Personnel Management annuity instead.
One switch point catches people who started paying on their own. If Social Security tells you it is paying you retroactive benefits and the new payment covers your premium, the deduction starts automatically, and Medicare says to stop your own Easy Pay or bank payments yourself.
If the benefit payment does not cover the whole premium, you are not stuck. Medicare states you get a premium bill for whatever amount you still owe.
What if I am not collecting Social Security yet?
You get the Medicare Premium Bill and you pay it yourself. How often it comes depends on what you pay for: a bill for Part B alone comes every 3 months, while a bill for Part A, or for a Part D income adjustment, comes every month.
That rhythm is published as a table on Medicare's payment page. It is worth reading twice, because Medicare's own pages flag the first bill as the one that arrives higher than expected.
Your first bill can be higher than the premium you were quoted. Medicare states that the first bill might include premiums owed for months not already billed, on top of the months ahead.
Medicare's own worked example runs like this. You sign up in February and coverage begins February 1st. Your first quarterly bill is dated March 28, arrives around April 10, and is due April 25. It covers February, March and April, plus the upcoming May, June and July.
After that opening bill, the account settles into its rhythm. Medicare says future bills are for 3 months at a time, and each one lists exactly which months you are paying for.
What payment methods are accepted?
Medicare accepts payment through your secure Medicare account, through Medicare Easy Pay, through your own bank's online bill payment service, and through the mail. Mailed payments can be a check, a money order, a credit or debit card, or a Health Savings Account card.
The account route runs through the government's own payment site. You log in, select Pay my premium, choose a card, a Health Savings Account card, or a bank account, and the payment finishes on the U.S. Treasury's secure Pay.gov. Medicare calls this the fastest way to pay.
| The route | How it works | The trap |
|---|---|---|
| Your Medicare account | Card, HSA card, or bank account, ending on Treasury's Pay.gov | Never create a separate Pay.gov account |
| Medicare Easy Pay | Free bank deduction on the 20th each month | Starting can take up to 6 to 8 weeks |
| Your bank's bill pay | The bank sends payment from savings or checking | Some banks charge a service fee |
| The mail | Check, money order, or card, plus the payment coupon | An unsigned card coupon comes back unprocessed |
Two of those traps are worth saying in prose. Medicare's instruction about Pay.gov is exact: use only your Medicare account to pay, and do not create or use a Pay.gov account for the payment.
The mail trap is just as exact. If you pay by card through the mail, complete and sign the coupon, because Medicare states an unsigned coupon means the payment cannot be processed and comes back.
When is the bill due?
Every Medicare premium bill is due on the 25th of the month, and in most cases the premium is due the same month you get the bill. Medicare must receive the payment by that date, so it says to submit yours at least 5 business days early.
The due date is the fixed point in the whole system. Whatever cadence your bill follows, and whichever route you pay by, the 25th is the deadline every bill shares.
Notice the wording that matters: received by, not sent by. A payment still in processing on the due date has not met it. The 5 business day cushion exists because processing time counts against you, not against Medicare.
Medicare's timeline example makes the window concrete. The bill for April is run on March 27, arrives in early April, and is due on April 25.
A missed payment starts a sequence this publication covers in its own missed payment article, and the first step is published right on the payment page: your next bill will also include a past due amount. The stake is published beside it, in Medicare's words rather than anyone's warning: if your payment is not processed on time, you risk losing your coverage.
What does the bill look like?
It is the Medicare Premium Bill, form CMS-500. It arrives around the 10th of the month, lists the dates you are paying for, and carries a payment coupon at the bottom. It bills people who pay Medicare directly for a Part A premium, Part B premium, or Part D income adjustment.
The dates on it are the part to actually read. Medicare states the bill pays for next month's coverage, and for future months if you are billed quarterly, so the bill in your hand is always buying time ahead.
Three situations put past months on it as well.
- You are getting your first bill
- You missed a payment
- Your premium amount changed
The coupon at the bottom is the working part of the document. Medicare's pages state three facts separately: bill payments go to PO Box 790355 in St. Louis, a Railroad Retirement Board bill goes to a different PO Box, 979024, and without the coupon Medicare cannot process a payment on time.
Read together, the coupon and the address, not the check, are what route your money. That reading is ours, not a rule printed in one place, and it is the part every ranked summary of this subject skips.
If the coupon is gone, Medicare gives the fallback itself: write your Medicare Number on the check or money order. The envelope that came with the bill already points at the right address.
What this means for you
Most premiums pay themselves through a benefit deduction. If yours does not, one bill reaches you around the 10th, is due on the 25th, and can be paid four ways. The coupon and the address decide whether a mailed payment lands on time.
The reliable habits are all published. Submit at least 5 business days before the 25th. Keep the coupon with a mailed payment and sign it when paying by card. Use your Medicare account rather than a Pay.gov account when paying online.
The first bill deserves patience rather than alarm. It can carry months you were never billed for, and Medicare's own example shows a February signup paying six months' worth in April.
For automatic deductions each month, this publication's article on Medicare Easy Pay covers the signup, the caps and the windows. For what happens when a payment is missed, read the article on missing a Medicare premium payment. For logging in, see the article on your Medicare account.
FAQ
Can I pay my Medicare premium with a credit card?
Yes, by two of the four routes. Online, you log into your Medicare account, select Pay my premium, and choose a credit or debit card, a Health Savings Account card, or a bank account, with the payment finishing on the Treasury's Pay.gov site.
Medicare notes card payments process faster than bank account payments there. By mail, a credit card, debit card or HSA card payment rides the payment coupon at the bottom of your bill, and the coupon must be completed and signed.
Medicare states that an unsigned coupon cannot be processed and the payment is returned to you. Medicare Easy Pay is the route that never takes a card, because it deducts from a checking or savings account only.
Where do I mail my Medicare premium payment?
That depends on who bills you, and the two addresses are different. A Medicare Premium Bill is paid to the Medicare Premium Collection Center, PO Box 790355, St. Louis, MO 63179-0355, using the payment coupon from the bottom of the bill and the return envelope that came with it.
A premium bill from the Railroad Retirement Board is paid to RRB, Medicare Premium Payments, PO Box 979024, St. Louis, MO 63197-9000. Both are in St. Louis, and they are not interchangeable.
Always include the coupon, because Medicare states it cannot process a payment on time without it. If the coupon is missing, write your Medicare Number on the check or money order.
Why is my first Medicare bill so high?
Because it can carry more than one month. Medicare states that your first bill might include premiums owed for previous months not already billed, on top of the period ahead.
Its own example: sign up in February with coverage from February 1st, and the first quarterly bill is dated March 28, arrives around April 10, is due April 25, and covers February, March and April plus May, June and July.
That is six months of premiums on one piece of paper, and nothing about it is an error. Medicare also lists two other reasons a bill can include past months: you missed a payment, or your premium amount changed. After the first bill, a quarterly account runs 3 months at a time.
What happens if my payment is late?
Medicare publishes the start of that sequence on its payment page. If you miss a payment, or if Medicare gets your payment late, your next bill includes a past due amount. The same page states the stake plainly: if your payment is not processed on time, you risk losing your coverage.
The safety margin is also published: Medicare must get your payment by the 25th, so submit it at least 5 business days before the due date. The full sequence, including what a delinquency notice is and what the government does and does not publish about grace periods, is covered in this publication's missed payment article.
Does the bill come every month?
Only for some premiums. Medicare's payment page publishes the cadence as a table. If you pay for Part B only, including any Part B income related adjustment, the bill comes every 3 months.
If you pay for Part A, the bill comes every month. If you pay a Part D income related monthly adjustment amount, that bill also comes every month.
Whatever the cadence, the bill arrives around the 10th of the month and is due on the 25th, and it lists the dates you are paying for, so the cover period is printed rather than guessed. The first bill is the exception that can span extra months.
Who do I contact about my Medicare premium bill?
For a bill from Medicare, the published number is 1-800-MEDICARE, which is 1-800-633-4227, with TTY users calling 1-877-486-2048. That is the number Medicare's payment page gives for billing questions, and the number its bill page gives for people having trouble paying premiums.
If your premium bill comes from the Railroad Retirement Board instead, the published number is different: call the RRB at 1-877-772-5772 with questions about that bill, and mail payments to its own PO Box.
The bill's own mailing page gives the same Medicare number for anyone having trouble paying premiums, which puts the call before the problem grows. Both pages print their numbers for exactly this purpose, and this publication's article on the Medicare account walks through logging in.
