Overview: Social Security covers approximately 96 percent of Americans and represents a significant retirement benefit to most retirees. Railroad workers covered by the Railroad Retirement Act, federal employees hired before 1984 and some state and local government employees are not covered.
An individual becomes eligible for Social Security benefits by working long enough and earning enough to accrue 40 quarters of coverage. These quarters are totaled to determine eligibility. The quarters do not determine the benefit amount. Benefits provided under Social Security include: (i) retirement benefits; (ii) disability benefits; (iii) death benefits; and (iv) survivor benefits.
Social Security is funded by taxes paid by both the employee and the employer and is calculated as a percentage of salary up to an annual maximum.
Medicare is a federal health insurance program that covers individuals age 65 or over, disabled workers under age 65 and individuals with end-stage renal disease. The Medicare program is funded by taxes paid by both the employee and the employer and is calculated as a percentage of salary with no annual maximum.
Medicare is made up of four programs:
Eligibility for Medicare benefits begins at age 65. Employees that work past age 65 are still eligible for Medicare. If an active employee is covered under both Medicare and the employer's group health plan, the group health plan is considered the primary health plan. For retirees, Medicare is considered the primary insurance and any coverage under an employer's health plan is secondary.
Trends: With baby boomers reaching retirement age, the financial strain on Social Security and Medicare is likely to increase.
Author: Tracy Morley, SPHR, Legal Editor
Updated to reflect the increase in the Social Security taxable wage base, effective January 1, 2019.
Updated to reflect the 2019 FICA tax rates and benefit amounts.
Updated to reflect the federal tax reform law's effect on family and medical leave benefits, effective January 1, 2018.
The Social Security Administration has issued inflation-adjusted figures for 2018, including the Social Security taxable wage base, the earnings tests for retirees who return to work, and the Social Security benefits quarter-of-coverage requirement and cost of living adjustment (COLA).
As mandated by the Internal Revenue Service, every employer that is organized as a corporation that transfers stock to any person upon the exercise of an incentive stock option must file Form 3921, Exercise of an Incentive Stock Option Under Section 422(b), on an annual basis.
Employment glossary definition of Medicare.
Employment glossary definition of MSA.
Employment glossary definition of PDP (Prescription Drug Plan).
HR guidance on Social Security and Medicare.