Medisure Agency

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Do I need Medicare at 65 if I’m still working?

Some people who keep working can delay Part B without a penalty. Others cannot. The difference is usually employer size and whether the coverage is creditable. This is education — not advice to drop or keep a specific employer plan.

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Employer size matters

If you or a spouse is still working and the employer has 20 or more employees, you may be able to delay Part B and enroll later during a Special Enrollment Period. Smaller employers follow different rules. Ask the benefits office for the rule that applies to you, in writing.

Part A is often still in play

Many people take premium-free Part A at 65 even if they delay Part B. Enrolling in Part A can affect Health Savings Account contributions. Confirm with the HSA administrator and Social Security before you enroll.

Creditable drug coverage

If the employer plan’s drug coverage is creditable (as good as Medicare’s standard Part D, on average), you may delay Part D without a penalty. Ask for the annual creditable-coverage notice. Marketplace (ACA) plans are generally not a substitute after you are eligible for Medicare.

Start with the worksheet

The still-working worksheet asks about the job, the employer, and Part B. It does not tell you to delay. If the job has ended and COBRA is the offer, read COBRA vs Medicare at 65. If you have an HSA, use the HSA stop date before Part A starts. Confirm both with the employer and with Social Security.

Common questions

Can this website tell me to delay Part B?
No. Employer size, creditable coverage, and Social Security rules decide that. Get it in writing from the employer and confirm with Social Security.
What if I have a Marketplace plan?
A Marketplace plan is generally not a substitute for Medicare after you are eligible. Missing Part B can mean a late-enrollment penalty. Confirm on Medicare.gov.

My Medicare Checkup

Answer a few questions about your ZIP code, what matters about cost and doctors, and where you get care. The summary shows the questions those answers raise. Confirm each one with the office, the plan, or Medicare.gov. A listing in a directory, or the name of a plan, does not show whether a doctor is in the network, whether a prescription is covered, or what you would pay this year.

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You will get a summary of the questions to verify. You can also talk it through with Alan.

For the other pages on this topic, open the Medicare at 65 guide.

Worksheet

Still working at 65?

A sketch of delaying Part B with employer coverage, HSAs, and the clock after coverage ends.

Read: Do I need Medicare at 65 if I’m still working?

Does the employer have 20 or more employees?
Whose job is the coverage from?
  • Ask the benefits office how many employees the group has, in writing. Size decides whether you can delay Part B.
  • HSA contributions generally must stop once you enroll in Medicare Part A. Timing Part A with an HSA is worth a Social Security conversation.
  • After qualifying coverage ends, a Part B Special Enrollment Period typically lasts eight months. Do not wait for fall Annual Enrollment to sign up for Part B.
  • Part D has its own creditable-coverage rules (including a 63-day gap). Ask whether the drug coverage is creditable.
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Worksheet

HSA stop date when Part A starts

The last month you can contribute to an HSA is the month before Medicare Part A starts.

Read: HSAs and Medicare Part A

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Worksheet

COBRA vs Medicare at 65

COBRA is not the same as current employer coverage. Delaying Part B for COBRA can mean a penalty.

Read: COBRA vs Medicare at 65

Where are you?

COBRA is continuation coverage after a job ends. It is not the same as current employer coverage. It generally does not let you delay Part B without a late-enrollment penalty. If you are turning 65, enroll in Part B on time unless you still have coverage from a current employer with 20 or more employees.

If you have both Medicare and COBRA, Medicare pays first on covered services. This is not a determination. Ask the COBRA administrator and Social Security.

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CalculatorMedicare eligibility dateSee when Part A and Part B can start at 65, and your Initial Enrollment window.CalculatorPart B late enrollment penaltyEstimate the 10% Part B surcharge for each full 12-month delay.

Where would you like to go next?

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