In the weeks after a death, the paperwork arrives in an order that has nothing to do with what matters. Somewhere in the pile are Medicare notices, insurance premium bills that should have stopped, and a Social Security payment that may need to be sent back. None of it is urgent in the way grief is urgent — but a few of these items have deadlines, and a few involve money that belongs to the family. Here is a practical walkthrough of what happens to Medicare when someone dies, in roughly the order it needs to be handled.
Step 1: Report the Death to Social Security
Social Security handles death reports for both Social Security and Medicare. You do not need to call Medicare separately — once Social Security has the report, Medicare is notified.
- The funeral home usually reports it. Give the funeral director the deceased person's Social Security number and confirm they will file the report.
- To report it yourself, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visit a local office. Death reports are accepted by phone or in person only — not online or by email.
- You can start the process before the death certificate is available, but you will need certified copies later, both for Social Security and for private insurers.
Step 2: Understand Which Payments Stop
Social Security is paid in arrears — the payment that arrives in a given month covers the previous month. The result surprises many families: the benefit for the month of death is not payable. If a payment arrives after the death for that month, it generally has to be returned. Do not deposit or spend it; if it was directly deposited, the bank will typically withdraw it once the death is reported.
Medicare coverage ends on the date of death. Claims for services received before that date are still processed normally, so bills and Medicare Summary Notices will keep arriving for a few months. Our guide to reading a Medicare Summary Notice explains what those documents show.
A surviving spouse may be eligible for Social Security survivor benefits and, in many cases, a one-time lump-sum death payment. Ask about both when you call — Social Security does not always raise them unprompted.
Step 3: Ask About a Part B Premium Refund
This is the item families most often miss. Medicare premiums are paid in advance, while Social Security benefits are paid in arrears. When someone dies partway through a period, premiums may have been paid for coverage that extended past the date of death.
- Part B coverage ends the last day of the month of death for premium purposes, and amounts paid beyond that may be refundable
- Refunds generally go to the estate, not automatically to a surviving spouse — unless the survivor is the legal representative or a qualifying next of kin
- The form is SSA-1724-F4, "Claim for Amounts Due in the Case of a Deceased Beneficiary," available from Social Security. You will need identifying information for the surviving family members and bank details for the payment
- If premiums were paid directly rather than deducted from a Social Security check — by check, bank draft, or Medicare Easy Pay — keep records showing who paid them
If a refund has not arrived within a few months, follow up with Social Security, or call 1-800-MEDICARE to check the status.
Step 4: Cancel Private Coverage Directly
Medicare notifies Medicare Advantage and Part D plans, but private insurers do not always act quickly, and Medigap insurers are not notified by Medicare at all.
- Medicare Advantage or Part D plan: call the number on the member card to confirm the enrollment has ended and ask about refunding any premium paid for coverage after the date of death
- Medigap policy: call the insurer directly. This one is on the family — a Medigap premium can keep drafting from a bank account for months if no one calls
- Automatic payments: if premiums came out of a bank account or credit card, ask each insurer in writing to stop them, and follow up to confirm
- Employer or retiree coverage: contact the plan administrator, since a surviving spouse's own coverage under that plan may also change
Keep a short log of each call — date, company, person you spoke with, and what they said. It saves considerable time if a refund is delayed.
Step 5: Handle Outstanding Bills and Claims
Medical bills for care received before the death do not disappear, but they also do not automatically become a family member's personal responsibility. A few points:
- Wait for Medicare to process claims before paying provider bills. The amount a provider bills initially is frequently not the amount owed after Medicare and any supplemental coverage pay
- Estates can appeal. An executor or legal representative may file an appeal on a denied claim on behalf of the deceased — see our guide to appealing a Medicare decision
- Watch for fraud. The identities of deceased beneficiaries are a known target for billing schemes. Review notices that arrive after the death and report anything unfamiliar to 1-800-MEDICARE; our guide to protecting yourself from Medicare fraud covers what to look for
What Changes for the Surviving Spouse
A spouse's death can change the survivor's own Medicare situation in ways that are easy to overlook.
Your Part B premium may change. Premiums are based on income from two years earlier, and the surcharge brackets are different for individual and joint filers. The death of a spouse is a recognized life-changing event, which means you may ask Social Security to recalculate your income-related surcharge using current income rather than the older tax return — using Form SSA-44. Our guides to IRMAA and appealing an IRMAA surcharge explain the process and the documentation involved.
You may gain a Special Enrollment Period. If you were covered under your spouse's employer or retiree health plan and that coverage ends, you may qualify for a Special Enrollment Period to sign up for Part B without a late enrollment penalty, and to join a Part D or Medicare Advantage plan. Timing rules are strict — see our guides to Special Enrollment Periods and late enrollment penalties.
Losing employer coverage may also create guaranteed issue rights for a Medigap policy, meaning you may buy certain plans without medical underwriting within a limited window. Our guide to guaranteed issue rights covers which situations qualify.
Your household budget changes too. With one Social Security check instead of two and possibly a different premium, it may be worth revisiting the numbers — our guide to Medicare costs in retirement is a starting point.
How to Get Help and Learn More
- Social Security (1-800-772-1213) — Report a death, ask about survivor benefits, and request Form SSA-1724-F4. TTY 1-800-325-0778.
- 1-800-MEDICARE (1-800-633-4227) — For questions about claims, notices, and refunds. TTY users can call 1-877-486-2048.
- State Health Insurance Assistance Program (SHIP) — SHIP counselors provide free, unbiased help, including with a survivor's own coverage decisions. Find your local office at shiphelp.org.
Summary and Next Steps
- Report the death to Social Security (1-800-772-1213) — this notifies Medicare; the funeral home can usually file the report
- The Social Security payment for the month of death is not payable and generally must be returned
- Medicare coverage ends on the date of death, but claims for earlier services continue processing
- Ask about a Part B premium refund using Form SSA-1724-F4; refunds generally go to the estate
- Call Medigap, Medicare Advantage, and Part D plans directly to cancel and stop automatic payments — Medigap insurers are not notified by Medicare
- A surviving spouse may qualify for an IRMAA recalculation, a Special Enrollment Period, and guaranteed issue rights for Medigap
If you are managing this for a family member, one call to Social Security and one call to each private insurer handles most of it. For the survivor's own coverage questions, a SHIP counselor can review the options at no cost.
