Medicare and working past age 65

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Most people first become eligible to enroll in Medicare around age 65. If you plan to keep working or have employer health coverage through a spouse, you have some decisions to make.

I plan to work past age 65. What do I need to do about Medicare?

Enrollment options for working past 65

How Medicare works with other coverage

Working past 65 video

I plan to work past age 65. What do I need to do about Medicare?

Start researching your Medicare options at least 6 months before your 65th birthday. Look for coverage that meets your needs so you’re ready to choose.

Find out the dates for your Initial Enrollment Period (IEP). This is a 7-month period surrounding your 65th birthday. You may not need to enroll in both Part A and Part B right away, but knowing your IEP dates will help you plan.

Do I have to get Medicare if I have employer coverage?

If you are still working and have health coverage through your employer or union, you may want to delay enrollment in Medicare. This includes federal or state employment and active-duty military service, and applies if you have coverage through your spouse’s work. In general:

If your employer has fewer than 20 employees, you may need to enroll in Medicare during your Initial Enrollment Period.

If your employer has 20 or more employees, you may delay Medicare enrollment, drop your employer coverage for Medicare, or have both Medicare and employer coverage.

If you have health coverage through a spouse’s employer, review the employer’s rules. You may be able to delay or you may need to enroll at 65.

What should I ask my benefits administrator before enrolling in Medicare?

The main question is whether you should keep your existing coverage. Ask if Medicare can work with your employer plan, and if retiree coverage is available.

Make sure you also ask how changing your insurance would affect your spouse and any dependents. Find out whether they will be eligible for COBRA if you drop employer coverage.

Enrollment options for working past 65

If you qualify, you can delay both Medicare Part A and Part B without penalty. When you stop working or lose employer coverage, whichever comes first, you will need to enroll during a Special Enrollment Period within eight months.

To avoid Part D penalties, you will also need to provide written proof of creditable prescription drug coverage — a plan that’s expected to pay, on average, at least as much as Medicare drug coverage does.

Medicare Part A is premium-free for most people, so you could enroll in only Part A while still working. If you have a health savings account (HSA), you will have to stop making contributions once you enroll in Part A. You can still use the funds for qualified medical expenses — including some Medicare costs such premiums, deductibles and copays.

Learn more about Medicare and HSAs

Medicare Part B charges a premium. Some people who work past 65 and have employer coverage delay enrolling in Part B and postpone paying the premium, then sign up later during a Special Enrollment Period.

In some situations, such as when an employer has fewer than 20 employees, you need to get Part B coverage during your Initial Enrollment Period to avoid penalties. Most people pay the standard Part B premium, but people with higher incomes may pay more.

Before you officially delay Medicare, make sure you have creditable drug coverage. This means your employer provides drug coverage at least as good as standard Medicare Part D coverage.

If your employer’s drug coverage isn’t creditable, you will need to enroll in a Part D plan during your Initial Enrollment Period[ to avoid the Part D late enrollment penalty. You will also need to get either Part A or Part B in order to get a Part D plan.

See your options

Learn more about your Medicare enrollment choices by answering a few questions.

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How Medicare works with other coverage

Yes. Ask your benefits administrator how your employer plan will work with Medicare. Depending on your situation, one will act as your primary coverage and one as secondary.

If you have COBRA before Medicare, you will need to enroll in Medicare when you become eligible. You may be able to delay Part D coverage if you can keep COBRA and it includes creditable drug coverage. If not, you have 63 days to get Part D coverage without penalty after losing COBRA.

If you enroll in Medicare Part A and Part B before COBRA, you can have both, but COBRA is optional. Medicare will be primary and COBRA secondary, and COBRA may pay some costs not covered by Medicare
If you enroll in Medicare Part A only before COBRA, you will need to enroll in Medicare Part B within eight months of your employment ending to avoid financial penalties, and you may also need to get Part D coverage. COBRA is optional as your secondary coverage.

Learn more about Medicare and COBRA

If you have TRICARE or CHAMPVA coverage, you will need to see if you qualify for premium-free Part A. If you are eligible, you will be required to enroll in both Part A and Part B to keep TRICARE or CHAMPVA coverage. If you are not eligible, enrollment is optional, but you could face late enrollment penalties. Ask your TRICARE and CHAMPVA benefits administrator for details.

VA benefits alone will not qualify you to delay enrolling in Medicare without penalty. If you have VA health coverage and work past 65, you will need to enroll in Medicare during your Initial Enrollment Period.

If you receive Federal Employees Health Benefits (FEHB), you can delay enrolling in Medicare Part A and/or Part B if your health insurance is based on employment (or a spouse’s employment) with an employer that has 20 or more employees.

What will happen when I retire?

If you delay Medicare enrollment past your 65th birthday, you will need to make a few changes once you retire or lose your employer coverage. At that point, you will have a Special Enrollment Period for enrolling in Medicare.

If you choose a Medicare Advantage (Part C) plan that includes drug coverage or a standalone Part D prescription drug plan, you will have 63 days to enroll without penalty.

If you choose Original Medicare (Part A and Part B) only, you will have up to 8 months to enroll.

If you have group retiree health coverage, contact the plan's benefits administrator to learn about how the coverage works with Medicare and what you need to do.

What else do I need to do if I delay enrollment?

If you receive Social Security or Railroad Retirement Board benefits, you will be enrolled in Medicare Part A and Part B automatically when you turn 65. If you receive Social Security benefits and are eligible for Medicare, you are required to enroll in Part A. If you want to delay enrollment in Part B, you will need to notify the Social Security Administration.

Watch Working past 65: When you may be able to delay Medicare

Bright music plays. Text appears alongside text bubble labeled "Working past 65...."

ONSCREEN TEXT: Medicare Conversations

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ONSCREEN TEXT: What to know about When you may be able to delay Medicare

Phil appears on screen, wearing a suit and sitting on a chair

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ONSCREEN TEXT: Phil Moeller, Author and Medicare expert

PHIL: Hi, I'm Phil Moeller. I write articles and books about retirement and health care and I've written a lot

of pieces about Medicare.

Illustrated icon slides up a number bar and stops at 65 with an illustration of a birthday cake on top of it

PHIL: When people approach 65 and decide to keep working, they have some important decisions to make about Medicare.

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ONSCREEN TEXT: 20 or more employees

PHIL: I'm gonna talk today about the decisions you need to make when you work for a large employer with 20 or more employees.

Phil appears on screen

PHIL: Medicare rules in that situation give you the right to do nothing if you choose, you can just keep your Medicare.

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PHIL: But it also sets up a series of possible decisions and I wanna sort of talk about those today.

Phil appears on screen

PHIL: They're really three pathways here.

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ONSCREEN TEXT: Employer plan only

PHIL: The first one, as I said is you can keep your employer plan and you don't need to get Medicare.

More text appears on screen with graphic of a document labeled "Employer plan" and a card labeled "MEDICARE"

ONSCREEN TEXT: Employer plan and Medicare

PHIL: The second approach is you can keep your employer plan and you can also get Medicare. And there's some situations where that makes sense.

More text appears on screen with graphic of a card labeled "MEDICARE"

ONSCREEN TEXT: Medicare only

PHIL: PHIL: The third pathway is, well, you can get Medicare and you can drop your employer plan. So these are the three pathways.

Let's talk about them in order.

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ONSCREEN TEXT: I only want my employer plan

PHIL: So when you decide that you're simply going to do nothing and keep your employer plan,

Phil appears on screen

PHIL: there's one wrinkle I wanna make sure you're aware of.

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ONSCREEN TEXT: Employer drug coverage

PHIL: Even though your employer is obligated to continue offering you health coverage, including drug coverage,

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ONSCREEN TEXT: Medicare drug coverage

PHIL: Medicare rules stipulate

that your drug coverage

in your employer plan has

to be at least as good

as a typical Medicare part D plan.

Phil appears on screen

PHIL: If it is fine and

Illustrated graphic of a document appears in the middle of the screen labeled "Notice of credible coverage"

PHIL: your employer has to give you a statement that attests to this, people don't know that their statement even exists let alone

they should ask for it, but your employer has a legal obligation provide this, it's a key piece of paper for you.

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ONSCREEN TEXT: (left) Medicare drug coverage

ONSCREEN TEXT: (right) Employer drug coverage

PHIL: Because if your plan is credible, you're fine. But if your plan's not credible,

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ONSCREEN TEXT: Medicare drug coverage

PHIL: then you have to get a part D plan even though you're gonna keep your employer coverage. In that situation, you

can get a part D plan

Text appears on the right side of the screen with a bed icon labeled "Required: Medicare Part A" and a stethoscope icon labeled "Not required: Medicare Part B"

PHIL: without having to also pay for part B. All you have to have as part A and you get a part D plan, you keep your employer plan.

Phil appears on screen

PHIL: That's the most significant sort of implication of keeping your employer plan as far as Medicare is concerned.

Text appears on screen with an illustrated graphic of a card labeled "MEDICARE" and a document labeled "Employer plan"

ONSCREEN TEXT: I want Medicare and my employer plan

PHIL: The second situation is you decide, "Well I think I want to keep my employer plan "and I also want to get Medicare."

Little icons of a checklist, a prescription bottle, hospital bed, and stethoscope appear at the top of the screen with a larger graphic of a

document labeled "Employer plan" at the bottom

PHIL: In that situation you

really need to pay attention

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card labeled "MEDICARE" at the bottom

PHIL: to what is Medicare gonna

give me or get for me that my employer plan is not gonna cover.

Phil appears on screen

PHIL: Historically, people tended to just keep their employer plans and they didn't worry about getting Medicare when they turned 65.

However, employer plans have changed a lot in recent years.

Text appears on screen with graphic of a document labeled "Employer plan" and a bar icon labeled "$3,245"

ONSCREEN TEXT: High deductible health plan

PHIL: Many people now have what are called high deductible health plans. You may pay three, four thousand dollars or even more out of pocket before

your employer health coverage starts helping you pay those bills. In that case, it can make a lot of sense to get a Medicare plan,

which can help pay that deductible for you.

Phil appears on screen

PHIL: Also, Medicare may cover some things that your employer plan doesn't,

Illustrated graphics appear of an ear labeled "Hearing", glasses labeled "Vision", toothbrush with toothpaste labeled "Dental",

and a gym bag labeled "Gym membership"

PHIL: in particular Medicare advantage plan can cover health clubs and dental, hearing, and also some vision coverage that your employer

plan may or may not cover as well.

Phil appears on screen

PHIL: So look at what your employer plan covers, see what you're exposed to in terms of costs and coverage features and then you may decide

that you actually want both.

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ONSCREEN TEXT: I only want Medicare

PHIL: The third thing is you look at your employer plan and you look at what Medicare offers and you say,

Graphics appear on screen. Left graphic is of a document labeled "Employer plan" with 3 gold circles above it. Right graphic is of a

card labeled "MEDICARE" with 2 gold circles above it.

PHIL: 'Well, that's pretty expensive to do both of these. "Maybe all I need is Medicare."

The Medicare card graphic takes over entire screen

PHIL: And that's quite possible.

Phil appears on screen

PHIL: You need to understand what Medicare will cover and see what would happen to you if you don't have that employer plan anymore.

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ONSCREEN TEXT: Employer coverage

PHIL:

In that case, you also

need to pay attention

to what happens to your family.

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PHIL: If your spouse and your children are insured on your employer plan, you probably wanna think long and hard before you drop that employer plan.

On screen text of "Employer coverage" is replaced with "State coverage"

PHIL: Although it's still possible that you and they could be better off if you dropped your employer plan and they went on a state

insurance exchange and got their coverage.

Phil appears on screen

PHIL: Those are decisions that you can make. One thing I will say is that

Illustrated grpahic of a checklist appears on screen with text "Don't wait too long"

PHIL: you don't wanna wait too long to make these decisions.

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PHIL: And you also don't wanna guess about what's going on.

Phil appears

PHIL: Because you can't make an informed decision if you're not informed, to say the least.

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ONSCREEN TEXT: So, what is the takeaway?

PHIL: We've covered lots of ground today, so let's recap a bit.

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ONSCREEN TEXT: 20 or more employees

PHIL: If you work for a large employer with 20 or more employees,

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ONSCREEN TEXT: Your employer must continure offering health coverage

PHIL: the employer must continue offering you health coverage. You have three decisions.

Text appears next to an illustrated graphic of a document labeled "Employer plan"

ONSCREEN TEXT: Employer plan only

PHIL: You're gonna just keep your employer plan,

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ONSCREEN TEXT: Employer plan + Medicare

PHIL: you're going to get Medicare plus your employer plan,

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ONSCREEN TEXT: Medicare only

PHIL: or you're gonna drop your employer plan and just get Medicare.

Phil appears

PHIL: All of these decisions should be based on information and knowledge about what's covered, what's not, what it costs.

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ONSCREEN TEXT: Talk to your employee benefits department

PHIL: That's information that you need to get from your employee benefits department, and you need to get it before you turn 65,

Phil appears

PHIL: don't doddle here. You really need to act on a timely basis to make sure you make informed Medicare decisions.

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ONSCREEN TEXT: What if I still have questions?

PHIL: If you have any more questions,

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ONSCREEN TEXT: Visit MedicareMadeClear.com

PHIL: you can go to medicaremadeclear.com and get additional information.

Phil appears

PHIL: Thanks so much for spending some time with me.

Blue text appears against white background. Bright music plays.

ONSCREEN TEXT: Medicare Made Clear brought to you by UnitedHealthcare

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