Tips, Tricks for Navigating Social Security and Medicare

Martha C. White and Kimberly Lankford,

AARP

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Published December 12, 2024

Social Security and Medicare play a big part in the lives of older Americans.

But these two government programs have changed through the years. Getting someone on the phone can be daunting, yet the automation you’re asked to adapt to can be confusing. How do we navigate this new landscape and make the system work?

As part of a year-end series, AARP gathered professional guidance on a number of topics to help you outsmart the system. Today: Social Security and Medicare.

Related:

5 ways to get help from Social Security

The Social Security Administration says customer service is improving. Really?

Figuring out Social Security can be difficult, as can reaching someone to actually answer your questions. The Social Security Administration has lost more than 10,000 workers since 2010 while the number of Americans it serves has risen by more than 13 million people, according to the Center on Budget and Policy Priorities.

The average phone wait time in the first seven months of 2024 was roughly 30 minutes. That’s an improvement over the 2023 average of about 36 minutes but still longer than the roughly 20-minute average callers could expect in 2019.

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1. Be prepared. Before calling or visiting a Social Security office, do as much research as you can on the agency’s website. “Consumers don’t always know the rules, so they don’t ask questions congruent with the rules,” says Philip Moeller, coauthor of Get What’s Yours: The Secrets to Maxing Out Your Social Security.

2. Know when to call. Mondays and the days after holidays are the busiest times for Social Security reps. If a matter can wait, call on a Friday, typically the best day of the week to get assistance by phone. The agency also recommends calling early in the morning.

3. Choose the callback option. As of September, less than a third of callers took advantage of the service rather than wait on hold. It’s available 8 a.m. to 7 p.m. local time weekdays.

4. Consider alternative locations. If you need to make an in-person visit to a Social Security office, check appointment availability in suburban areas, which tend to be less busy, says Kevin Chancellor, a certified Social Security claiming strategist and CEO of Black Lab Financial Services.

5. Take advantage of AARP resources. Get the latest news, expert advice and answers to frequently asked questions about Social Security benefits at AARP’s Social Security Resource Center. Or watch the AARP Social Security Explained YouTube series and AARP’s Social Security on-demand webinars.

Related:

4 ways to weigh original Medicare vs. Advantage

Medicare Advantage enrollment has been growing. Should you consider a switch from original Medicare when open enrollment rolls around again starting Oct. 15, 2025?You would not be alone.

An increasing number of Medicare beneficiaries choose the plans from private companies — rising from 19 percent of eligible Medicare beneficiaries in 2007 to 54 percent in 2024, according to KFF. If you’re on original Medicare, you can switch to a Medicare Advantage plan, but generally not until the annual open enrollment period from Oct. 15 to Dec. 7.

1. Consider the copays. When shopping for a Medicare Advantage plan, monthly premiums are only part of the story. In fact, two-thirds of Advantage plans charge no premiums other than the Part B premium in the 2024 plan year, according to KFF. And remember that axiom “you don’t get something for nothing.” Be sure to check the copays.

“If you have a five- to seven-day hospital stay and your copay is $200 to $300 every day, that could add up pretty quickly,” says Meredith Freed, a KFF senior policy manager.

2. Understand provider networks. The majority of medical providers accept original Medicare, and you generally don’t need a referral to see a specialist. But Medicare Advantage plans use provider networks, so make sure you can see the doctors you like.

“Many people come from employer plans that have provider networks, and they may not find it as big of an issue if that’s something they’re already familiar with,” Freed says.

3. Prepare for authorizations — and appeals. Advantage plans have more prior authorization requirements than original Medicare. “We found in our surveys that prior authorization does serve as a barrier to care for some beneficiaries in Medicare Advantage getting the care they need,” says Gretchen Jacobson, vice president of Medicare for the Commonwealth Fund.

Service denials aren’t all that common; in 2022, 7.4 percent of the 46 million Medicare Advantage prior authorization requests were denied in whole or in part, according to KFF. But you can appeal a denial; 83 percent of those appealed were fully or partially overturned.

4. Take advantage of AARP resources. AARP has educational materials to help Medicare beneficiaries and their families make informed decisions. Check out AARP’s Medicare Resource Center, the AARP Medicare Explained YouTube series and Medicare webinars and online learning.

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Martha C. White writes about business, finance and the economy. Her work has appeared in The New York Times, CNN, Time, NBC News, Money and other outlets.

Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.