Still Working at 65? Don’t Assume You Must Enroll in Medicare
Updated: Sep 25
If you plan to continue working after age 65, you may be wondering whether you must enroll in Medicare or can remain on your employer’s health plan. The answer is: it depends.
Some people can delay parts of Medicare without a late-enrollment penalty. Others may need Medicare when they turn 65—even if they are still working and covered by an employer plan.
Start with your employer coverage
One of the first things to determine is whether your health coverage is based on your or your spouse’s current employment. The size of the employer also matters.
Generally:
If the employer has 20 or more employees, the employer plan usually pays first and Medicare pays second. You may be able to delay Medicare Part B without a penalty while that active employer coverage continues.
If the employer has fewer than 20 employees, Medicare generally pays first. In that situation, enrolling in Medicare may be necessary for your employer plan to pay benefits properly.
There can be exceptions, so don’t rely only on the number of employees. Ask the employer or benefits administrator how the plan coordinates with Medicare and whether you need to enroll in Part A or Part B at age 65. Medicare also provides an overview of working past 65.
Compare more than the premiums
Even if you can remain on your employer plan, that doesn’t necessarily mean you should—or shouldn’t. Compare the coverage available through work with your Medicare options. Its a good idea to consider:
Monthly premiums
Deductibles and other out-of-pocket costs
Prescription drug coverage
Doctor and hospital access
Coverage for a spouse or other dependents
Your expected retirement date
Sometimes remaining on the employer plan makes the most sense. In other situations, Medicare may provide coverage that better fits your needs and budget.
A couple of important cautions
Coverage through active employment is different from COBRA or retiree coverage. Those types of coverage may not allow you to delay Medicare without consequences.
If you contribute to a Health Savings Account, enrolling in any part of Medicare can also affect your ability to continue making contributions. Be sure to investigate the HSA rules before enrolling.
Don’t make assumptions
Turning 65 while working doesn’t automatically mean you must leave your employer plan. It also doesn’t mean that delaying Medicare is always safe.
Before deciding, confirm how your current coverage works with Medicare and compare the costs and benefits of each option. A little planning can help you avoid enrollment problems, unexpected medical bills, or late-enrollment penalties.
At BeneCentric, we’ll help you understand the questions to ask and explain your Medicare options in plain language. Our guidance and support are always provided at no cost to you, so you can make your decision with clarity and confidence. Reach out to us today.
