Medicare when working past age 65

You first become eligible to enroll in Medicare around age 65. But if you plan to keep working or have employer health coverage through a spouse, you have some options to consider before signing up for Medicare. Here you'll find the resources and tools you need to help learn about your Medicare enrollment options, and to make confident decisions about getting or delaying Medicare coverage.

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

Delaying Medicare when working past 65

Your Medicare Special Enrollment period

Medicare when working past 65 FAQ

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

Find out what your Medicare enrollment choices are by answering a few questions below.

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If an employer has 20 or more employees, generally you can choose to delay Medicare enrollment, drop your employer coverage for Medicare, or have both Medicare and employer coverage.

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

If you have health coverage through a spouse's employer, what you can do will depend on the employer's rules. You may be able to delay or you may need to enroll at age 65.

Questions to ask your employer’s benefits manager before enrolling in Medicare

Before you do anything about enrolling in Medicare, you need to talk with your employer’s benefits manager. You need to understand if your employer’s insurance qualifies as creditable coverage that could allow you to delay Medicare as well as find out how Medicare and your employer’s coverage may work together. In some cases, your employer’s coverage will enable you to put off Medicare enrollment, and in other cases, you may be required to take full Medicare benefits at age 65 even if you continue working.

Questions to ask your employer’s benefits manager include:

Will my health insurance change if I enroll in Medicare? If so, how?

How much is deducted from my paycheck for my employer health insurance?

Do I have creditable coverage?

How will my covered dependents (spouse and family) be impacted if I choose to get Medicare?

This information will help you weigh your choices and decide what’s best for you. You may decide to enroll in Medicare Part A, Part B, or both. Or you may be able to delay enrolling in Medicare altogether until you retire.

Delaying Medicare when working past 65

Even if you plan to keep working, you still have a 7-month Initial Enrollment Period (IEP) when you turn 65. You have a number of Medicare decisions to make when you turn 65, and this is especially true when you have other health insurance. It’s a good idea to start learning about your choices ahead of turning 65. Preparation can help you get the coverage that best meets your needs while avoiding unnecessary costs and give you confidence in whatever decision you end up with.

If you qualify to delay both Medicare Parts A & B, you can do so without penalty as long as you enroll within eight months of either losing your (or your spouse's) employer coverage or ceasing to work, whichever comes first. You will enroll during a Special Enrollment Period and will need to also provide written proof of creditable drug coverage to avoid Part D penalties.

Medicare Part A is usually premium-free for most people, so you could opt to enroll in only Part A while still working. However, if you have a health savings account (HSA), be aware that once you enroll in any part of Medicare you cannot continue to make contributions to your HSA. If you decide to get Medicare and stop contributing to your HSA, know that you can still continue to use the funds for qualified medical expenses — including some Medicare costs such premiums, deductibles and copays.

You may want to delay Part A if you have an HSA and want to continue contributing to it. If you decide to get Medicare coverage and stop contributing your HSA, you can continue to use the funds for qualified medical expenses — including some Medicare costs.

Medicare Part B charges a premium, so if you can delay without penalty, you may want to. Some people who work past 65 and have employer coverage delay enrolling in Part B just to postpone paying the premium and then sign up later during a Special Enrollment Period. If you don’t qualify for a Special Enrollment Period, even if you’re still going to work past 65, you need to get Part B during your Initial Enrollment Period to avoid financial 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 drug coverage is at least as good as the standard Medicare Part D plan 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. Consequently, you'll also need to get either Part A or Part B in order to get a Part D plan.

You don't need to provide notice that you'd like to delay enrolling unless you're receiving Social Security or Railroad Retirement Board benefits. If you are receiving either, you'll be automatically enrolled in Medicare Parts A & B when you turn 65, and you'll need to let Social Security know you wish to delay Part B. By law though, if you receive Social Security benefits and are eligible for Medicare, you must also have Medicare Part A.

Medicare and working past 65 tips

If you are planning to work past the age of 65, you may have questions about how this choice impacts Medicare eligibility and enrollment. Use these helpful tips to answer some of the most commonly asked questions, or visit this Medicare Made Clear guide for additional information.

Start researching Medicare and your options 6 months prior to your 65th birthday and record your Initial Enrollment Period (IEP) dates

Determine if you need to enroll or if you can choose to delay your decision

Ask your employer’s benefits administrator about how Medicare works with your employer coverage and if taking it may impact your spouse or dependents

Learn how your spouse/dependents’ insurance options may be impacted if you drop the employer coverage

Gather all records and copies of your health insurance for proof of creditable drug coverage

Research how Medicare works with HSAs and COBRA

Familiarize yourself with the Special Enrollment Period (SEP) for people working past age 65 and learn what you may need to do to avoid late-enrollment penalties

Get your comprehensive Medicare guide

You'll get timely email reminders and information to help you navigate your Initial Enrollment Period as smoothly as possible.

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Enrolling in Medicare when working past 65

Even if you plan to keep working, you still have a 7-month Initial Enrollment Period (IEP) when you turn 65. Moreover, if an employer has fewer than 20 employees or your spouse's employer requires you to get Medicare to remain on their plan as a dependent, you will need to enroll during your IEP to avoid late enrollment penalties.

Learn about my Initial Enrollment Period and Medicare choices

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.

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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.

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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.

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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.

The adult male icon is separated to the left side of the screen with text "Medicare coverage"

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.

Additional text "Don't guess" appears on checklist graphic

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,

White text appears on screen against dark blue background

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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Your Medicare Special Enrollment Period

When you retire or lose your employer coverage, you will have an 8-month Special Enrollment Period in which to enroll in Medicare. You will have up to 8 months to enroll in Parts A and/or B, but only the first two months to enroll in Parts C and/or D.

Find your Special Enrollment Period dates

Medicare when working past 65 FAQ

You can have Medicare and employer coverage as well as other types of coverage such as COBRA, TRICARE, CHAMPVA, VA and FEHB. How Medicare works with each of these varies.

Many people ask, "Can I sign up for Medicare and still work full time?" The answer is, yes you can. Always talk to your benefits administrator to understand specifically how your employer plan will work with Medicare, but you can have both employer health coverage and Medicare. Depending on your situation, one will act as your primary coverage and one as secondary.

How COBRA and Medicare work together depends on which you get first. You could have COBRA first and then become eligible for Medicare, or you could already have Medicare already and then become eligible for COBRA. See below for each possible situation:

See how COBRA and Medicare can work together in this article

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

Have 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.

Have Medicare Part A only before COBRA: You need to get Medicare Part B within eight months of your employment ending to avoid financial penalties, and you may also need to get Part D. COBRA is optional, but you can have both, and it’ll be your secondary coverage.

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. It’s best to talk with your TRICARE and CHAMPVA benefits administrator to learn more.

VA benefits alone will not qualify you to delay Medicare without penalty, so if you have VA health coverage and are still working past 65, you will need to enroll in Medicare during your Initial Enrollment Period.

Individuals with Federal Employees Health Benefits (FEHB) can opt to delay enrolling in Medicare Part A and/or Part B if they have health insurance based on employment (or a spouse's employment) with an employer who has 20 or more employees.

It's important to understand what your options are once you retire. The first step is to find out if you can keep the coverage you have now when you retire, and whether or not it can be combined with Original Medicare (Parts A and B) coverage. If you have group retiree health coverage, you'll need to contact the plan's benefits administrator to learn about how the coverage works with Medicare and what you need to do.

Supporting you through your Medicare journey

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Medicare when working past age 65

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

Questions to ask your employer’s benefits manager before enrolling in Medicare

Delaying Medicare when working past 65

Delaying Medicare Part A and Part B

Enrolling only in Part A

Enrolling in Part B

Having creditable drug coverage

Do I need to notify anyone if I’m delaying Medicare?

Medicare and working past 65 tips

Enrolling in Medicare when working past 65

Your Medicare Special Enrollment Period

Medicare when working past 65 FAQ

Can I have Medicare and employer coverage?

How do COBRA and Medicare work together?

Can I have TRICARE, CHAMPVA and VA benefits with Medicare?

How do Federal Employee Health Benefits work with Medicare?

What happens when I retire?

Chat with UnitedHealthcare

Call UnitedHealthcare

Find a plan

Meet with us

Already a member?