Do I Need Medicare if I Work Past 65?

medicare at 65

The tradition of retiring at age 65 is not as common as it once was. Those over the age of 65 are working later in life for many reasons. The life expectancy is longer for this demographic than that of past generations; meaning they are staying healthy and able to work longer.

They are better educated, leaving them wanting to finish out a fulfilling career. Lastly, the inevitable changes to Social Security benefits have made it necessary for many to continue working to build up their retirement funds.

With that said, beneficiaries are often left wondering whether they need to enroll in Medicare now or wait until they retire. Much of it depends on your individual situation and personal preferences.

Here are the main points to take into consideration if you are working beyond 65.

The Size of Your Employer Is Important

The size of your employer will be the first factor to consider for your decision.

Less Than 20 Employees

If your employer has less than 20 employees, you need to enroll in Medicare during your Initial Enrollment Period. In this case, Medicare will become your primary insurance and your employer group plan will become secondary.

Group plans to monitor the age of their employees who are Medicare beneficiaries. This creates the possibility that they could stop paying your claims if they realize you are eligible for Medicare as your primary insurance but are not enrolled in it when you should be. Another reason you will want to enroll now is to avoid penalties that would incur if you do not sign up during your Initial Enrollment Period for Medicare.

More Than 20 Employees

Medicare considers employers with more than 20 employees, large employers. If you work for a large employer, you will have three options during your Initial Enrollment Period.

  1. Keep only your group insurance and delay enrolling in Medicare until you retire.
  2. Disenroll from your group plan and enroll in Medicare.
  3. Keep your group plan and enroll in Medicare for extra coverage.

There is no standard choice here. The best thing to do is to research and compare premiums for both your group plan and Medicare to see which is best for you. If you decide to go with option one, you will have a Special Enrollment Period after retiring to enroll without penalty.

Your Retirement Benefits

Some employers offer health plans to their retirees. Medicare is always primary for these types of health plans. If you have retiree benefits, you will still need to enroll in Medicare.

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COBRA is another plan we often get questions about. COBRA allows retirees to have health coverage through their form employer for up to 18 months after retirement. However, Medicare requires enrollment within the first 8 months of having COBRA if you are over 65.

Skipping Medicare Altogether

This is a bad idea. Choosing to forego Medicare enrollment entirely would leave you in a bad spot. If you do not sign up on time, you risk getting late penalties and delayed coverage effective dates. You would be surprised how often we see this simply because retirees just do not know the rules.

Getting Enrolled in Medicare

Most people qualify for premium-free Part A. In the majority of cases, it is your best bet to just get enrolled in Part A at age 65. It will coordinate with your group coverage and may reduce the cost of your hospital expenses if you have a hospital stay. You can delay Part B until later since you will pay a monthly premium for it. Also, your group plan already has outpatient coverage Part B would be redundant.

Be sure to check if your group plan includes drug coverage. If it doesn’t, you will need to enroll in Medicare Part D.

You can enroll in Medicare online through the Social Security website, in person at your Social Security office, or over the phone during your personal Initial Enrollment Period (IEP). Your IEP last for 7 months in total. This is a one-time window that begins a full three months before the month that you turn 65 and lasts for a full three months after turning 65.

Dealing with Medicare while still being in the workforce is tough. It is important to know what type of coverage your employer has and what may change if you enroll in Medicare.

Danielle Roberts is a Medicare insurance expert at Boomer Benefits. You can read more about Medicare and Employer coverage at

Disclaimer – The views or opinions stated in the resources collected here do not necessarily reflect those of FHT. FHT assumes no responsibility for any discrepancies or errors contained in these resources.

For additional benefits, you can enroll in a Medicare Advantage plan, also known as Medicare Part C, and in some cases, it will also include your Part D prescription drug coverage.

This post was last modified on November 17, 2022 3:01 am

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