You first become eligible to enroll in Medicare around age 65. But if you plan to keep working or you have employer health coverage through a spouse, you have some options to consider when signing up for Medicare. Here you'll find the resources and tools you need to help learn about your Medicare enrollment choices, and to make confident decisions about getting Medicare.
When can I change my Medicare coverage?
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, you may be able to delay or you may need to enroll at age 65. You can have both Medicare and the employer coverage. What you can do will depend on the employer's rules.
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. 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. You may also decide enrolling in Medicare is your best choice even if you can delay, and in this case, enrolling during your IEP is a good idea.
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.
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 you must also have Medicare Part A.
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.
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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. And 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 have Medicare already and then become eligible for COBRA. Each situation is different. See how COBRA and Medicare can work together in this video .
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.
If you have TRICARE or CHAMPVA coverage, you will need to see whether or not you are qualified 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.
What happens when I retire?
It's best 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.