Medicare and Working Past 65

Turning 65 doesn’t always mean retiring. If you’re still working—or covered by a spouse’s employer plan—you may want to wait about beginning  Medicare. The right choice depends on your situation, and knowing the rules can save you money and help you avoid penalties later.

Do I Have to Sign Up for Medicare If I Have Insurance Through my Employer ?

It depends on your employer’s size and your coverage type:

  • Large employer (20+ employees): You may choose to delay Medicare and keep your coverage through your employer.

  • Small employer (fewer than 20 employees): You will most likely have to sign up for Medicare at 65 to avoid gaps in coverage.

  • Spouse’s employer coverage: The rules vary. Some employers let you delay Medicare, while others require enrollment at 65.

Before deciding, found out the answer to questions such as:

  • Does my plan (or my spouse’s plan) count as creditable coverage under Medicare?

  • How would Medicare work with my current insurance?

  • What happens to my spouse or dependents if I move to Medicare?

  • Compare cost and coverage – How much do I pay now for employer coverage compared to Medicare costs?

Delaying Medicare While You’re Working

If your employer coverage is creditable, you can delay Medicare and sign up later during a Special Enrollment Period (SEP)—without a penalty.

  • Your SEP lasts 8 months after you stop working or lose employer coverage (whichever happens first).

  • If you miss this window, you may face permanent late-enrollment penalties.

Choosing What to Enroll In

  • Part A (Hospital Insurance): Most people qualify for premium-free Part A, so enrolling is often a no-brainer. If you have a Health Savings Account (HSA), enrolling in any part of Medicare means you can no longer contribute to your HSA (though you can still use existing funds).

  • Part B (Medical Insurance): Part B has a monthly premium. If you’re still covered by an employer plan that’s considered creditable, you may delay Part B and sign up later.

  • Part D (Prescription Drug Coverage): Make sure your employer’s drug coverage is creditable. If it’s not, you’ll need to join a Part D plan during your Initial Enrollment Period to avoid a penalty later.

Do I Need to Notify Medicare If I’m Delaying?

  • If you are not getting Social Security or Railroad Retirement benefits – You don’t have to notify anyone.

  • If you are already getting Social Security or Railroad benefits –You’ll be automatically enrolled in Parts A & B at 65. If you want to delay Part B, you’ll need to contact Social Security. You will let Social Security know that you want to delay Part B.

Planning Ahead

  • Start researching your Medicare options about 6 months before your 65th birthday.

  • Remember your Initial Enrollment Period dates so you don’t miss deadlines.

  • Double-check with your employer about  how Medicare works with your current plan.

  • Ask how your spouse  and/or dependents’ coverage may change if you move to Medicare.

  • Learn how Medicare interacts with HSAs and COBRA.

If you’re working past 65, you may have the flexibility to delay Medicare. The first step is making sure your employer coverage is creditable. Remember you will have deadlines, and knowing those will help avoid penalties or gaps in your coverage.