Do I Need Medicare If I'm Still Working?

Working at 65? Know whether to enroll or delay. Call 1-800-MEDIGAP.

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Quick answer

If you are still working at 65 with health coverage from an employer of 20 or more employees, you can usually delay Part B penalty-free and enroll later through a Special Enrollment Period. Many still take premium-free Part A. Smaller employers may require you to enroll in Medicare.

Working past 65 raises a key question: do you take Medicare now or wait? The answer depends on your employer. Here is how to decide.

Should I enroll in Medicare while still working?

It depends mainly on your employer's size. If your employer has 20 or more employees, your group plan usually pays first, and you can delay Part B without penalty, enrolling later through a Special Enrollment Period when you retire. Many people still take premium-free Part A since it costs nothing. If your employer has fewer than 20 employees, Medicare typically becomes the primary payer, so you generally must enroll in Part B at 65 to avoid coverage gaps. The rules are easy to get wrong. Call 1-800-MEDIGAP to confirm your situation.

What mistakes should working seniors avoid?

The biggest trap is assuming COBRA or retiree coverage lets you delay Part B; it does not. Only active employment coverage qualifies for the penalty-free Special Enrollment Period. Another mistake is contributing to a Health Savings Account after enrolling in any part of Medicare, which is not allowed and can cause tax penalties. Many also miss the eight-month window to enroll after employment ends. These errors cause lifelong penalties or coverage gaps. A licensed agent at 1-800-MEDIGAP can review your coverage and timing to keep you protected.

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Frequently asked questions

Do I have to sign up for Medicare at 65 if I am working?+

Not always. If your employer has 20 or more employees, you can usually delay Part B without penalty and keep your group plan. If the employer has fewer than 20 employees, you generally must enroll. Many still take free Part A. Call 1-800-MEDIGAP to confirm.

Can I have both Medicare and employer insurance?+

Yes. Many people have both. For employers with 20 or more workers, the group plan usually pays first and Medicare second. Coordination rules determine which pays first. A licensed agent at 1-800-MEDIGAP can explain how your two plans work together.

Does COBRA count as coverage to delay Medicare?+

No. COBRA and retiree coverage do not count as active employer coverage for delaying Part B without penalty. Relying on them is a common, costly mistake. If you are on COBRA near 65, call 1-800-MEDIGAP immediately to avoid penalties.

Can I contribute to an HSA while on Medicare?+

No. Once you enroll in any part of Medicare, you can no longer contribute to a Health Savings Account, though you can spend existing funds. If you want to keep contributing, you may need to delay Medicare. Call 1-800-MEDIGAP to plan correctly.

When do I enroll in Medicare after I stop working?+

When your active employer coverage ends, you get an eight-month Special Enrollment Period to enroll in Part B without penalty. Acting promptly prevents a coverage gap. Call 1-800-MEDIGAP as soon as you know your retirement date to enroll on time.

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