If a senior is turning 65 but still working, should they enroll in Medicare or delay it?
Answered by 41 licensed agents
If you have employer-based health insurance through your or a spouse's current employment, where there are more than 20 employees, and you're happy with the costs, such as monthly deductions/premiums and coverage, like potential out-of-pocket costs, you can delay Medicare enrollment without accruing penalties. If this is you, it's best to schedule a quick call so we can discuss your situation. Chad
Suppose they have a Medicare-qualified group insurance plan. In that case, they do not necessarily need to enroll in Medicare until they retire, and they then have 63 days to make that decision without penalties. However, one would need to analyze correctly what the two different coverages would consist of, the cost, co-pays, and deductibles before making the final decision.
They need to look at the cost. If an employer plan is cheaper, I always recommend they stay on the employer plan. With Medicare, you have a part B that you pay for, Social security will take your Part B premium out of your social security. If you do not take social security yet, you will be billed for your apart B premium. In 2025 is is $185.00
Hitting 65 while still working means you’re automatically getting Medicare Part A—it’s free for everyone, no opting out, and it’s a solid backup to your employer’s coverage. From my experience, signing up for Part B makes sense too; it’s usually way cheaper than what you’d pay monthly through a job’s plan, often has no annual deductible, and throws in extra perks you won’t find in most group benefits. Delaying Part B is an option if your work insurance is top-notch, but I’ve seen Part B save folks money and headaches, so I’d lean toward enrolling now!
The key questions here are, how good is the senior's employer group plan and what is the cost? Then compare that with the cost of Medicare Part B, typically $ 185 / month, in combination with a Medigap or Advantage plan.
Whether a senior turning 65 should enroll in Medicare or delay it while still working depends on their job situation—specifically, their employer’s size and health plan. Here’s how it breaks down:
If the employer has 20+ employees: The company’s group health plan is usually "primary" (pays first), and Medicare is "secondary." In this case, they don’t have to enroll in Medicare right away. They can stick with the work plan and delay Medicare Parts A and B without penalties, as long as the job coverage is “creditable” (meets Medicare standards). Part A (hospital coverage) is free, though, so some sign up for it as a backup since it can coordinate with the work plan. Part B (doctor visits, outpatient care) has a monthly premium, so delaying it often makes sense to avoid double costs.
If the employer has fewer than 20 employees: Medicare typically becomes primary, and the work plan secondary. Here, they should enroll in Medicare Parts A and B at 65, because the work insurance might not cover much unless Medicare kicks in first. Skipping it could mean gaps in coverage or higher out-of-pocket costs.
Other Factors: If their work plan is pricey or skimpy (high deductibles, limited drug coverage), switching to Medicare might save money or improve care, even with a big employer. They’d need to compare premiums, copays, and drug formularies. Also, if they have an HSA, signing up for Medicare stops HSA contributions—something to weigh if they’re still saving there.
How to Delay: If they skip Medicare Part B (the part that costs a monthly premium) at 65 because of a solid work plan, they will get a Special Enrollment Period (SEP) later to turn on Part B and enroll in a plan in short order at that time.
This is a very tricky question. There are many variables. Each individual should seek guidance to make sure that they make the solid choice and avoid penalties, down the line.
It depends some companies require you to apply for Medicare party and B. But if they don’t, it’s not necessary until you stop your employer coverage and some cases Medicare ANB is actually a better route to go along with having either a advantage plan or a Medicare supplement so that’s something that would be necessary to explore.
It depends. Are they on their Employer’s group coverage plan? Is it creditable? Is it more expensive than Medicare? There are a lot of factors to consider. Do you have a spouse under 65 that you are providing coverage for? Does is make sense financially?
This is why it’s important to work one on one with an agent/broker in order to determine what is right for you.
It depends! We are careful to use " depends" in a Senior discussion! Lol!
Enrolling in a premium free Part A Medicare could penalize someone who is trying to maximize their Tax Free accumulation goal. However, in most cases enrollment in Part A is a good strategy if there is no Health Savings Account available for our clients. Enrolling in Part B and keeping your Employee Group Coverage or disenrolling is a complex and should only be made after meeting with a highly competent Medicare licensed agent.
If they work for a company that has more then 20 employees and the coverage is being paid in FULL then YES delay until retirement - IF you work at a company with less then 20 employees, then YES enroll into Medicare - ALSO if you are paying a portion of your coverage at work - it's BEST to see what it would cost if you were on your OWN - it could be quite less and BETTER coverage and lower costs in general.
If you are turning 65 and still working you generally will have the option to either continue with your employer group health plan (EGHP) or switch to Original Medicare- Part A and Part B. Some EGHPs require you to take Medicare at 65- so this is something you will want to check on with your Human Resources/Benefits department.
The first step is to enroll in Original Medicare through the MySSA portal online via the Social Security website (www.ssa.gov). You can apply online for Medicare only- taking only about 20 minutes of your time.
Once you are enrolled in Part A/Part B of Medicare, my recommendation is to work with a healthcare broker who can compare your Medicare options to your EGHP and provide you with the information you need to make the best decision for you. In addition to looking at cost and coverage comparisons, they will ensure your EGHP is creditable, so that you are not at risk of a penalty for Part B or Part D.
A Medicare broker will also be ready to assist you when you do stop working and wish to enroll in a Medicare Advantage (Part C) or a Medicare Supplement (Medigap) with a stand alone Prescription Drug Plan (Part D). They will also ensure you enroll during your Special Enrollment Period to avoid penalties and ensure no gap in coverage.
If you are working for an employer with 20 or more employees and you have health insurance with them that is on average equal or better than what Medicare offers, then you could delay enrolling in Medicare. For some people it may make sense to enroll in Part A only. If you are paying a high premium for your employer health insurance, you may want to compare your employer plan with your Medicare options.
Delay it. If your employer coverage is working for you and your needs, as well as not costing you an arm and a leg then go ahead and “delay part B”. Medicare will have a known cost of at least $185 per month (part B premium) + whatever plan you add on top of that. If you’re currently paying more than that and not “using your employer plan benefits” then you may be better off getting onto Medicare. A broker can help you make a “pros and cons” list and think through your options.
Always good to talk to the professional either way! But some take their Part A as a backup to the existing coverage, even if they are deferring the Part B. But complete cost comparisons should be done to evaluate your best positioning.
You can apply for Part A which is premium free if you or your spouse worked and paid taxes for at least 10 years. The Part B can be delayed without a penalty if you decide to keep your employer insurance but you also have an option to compare group coverage vs Medicare coverage in terms of premium and benefits.
This is important to review with a Medicare broker. If you are able 6-12 months before Turning 65 review with a broker your thoughts about continuing to work and if you are able to stay on your Employer plan. Comparing an Employer plan to Medicare to understand if delaying Part B is necessary.
If this is a decision you are making contact me to review.
Turning 65 starts the ball rolling as MEDICARE is automatic for all who are entitled to it. Whether the Senior continues to work, whether their current employer has “credible” insurance, perhaps the Senior is ex-Military…there are many facets that determine the answer to this question.
And as always I recommend speaking with a Licensed Independent Broker who has studied hard to obtain their State License, and then studied further to become appointed to enroll clients in all major Insurance Carriers in a given area.
Depends on the plan. Most my clients go on Medicare even if it costs more because the coverage is stronger. For instance a Plan G is only a 257 deductible then you have 100% Coverage.
They can delay enrollment in Medicare A and B as long as they are working for a group of 20 or more people and the employer coverage is a good as Medicare. However, we always recommend that they go ahead and enroll in Part A.
The decision to enroll in Medicare is partially decided on their current coverage. Cost of the current coverage and the limits of that coverage play a big part in determining the need for additional coverage. Sometimes it is best to have Medicare as a second coverage and utilize other ways to cut back on the cost of Medicare!
If they have what is called creditible coverage (ie; coverage as good as or better than medicare) then they do not have to take medicare a and b at 65. Sometimes however their company plan may cost them MORE than medicare so that is a consideration. If they do decide they want to take medicare at 65, the other caveat is not contributing to their HSA for the 6 months leading up to that date.
If turning 65 and still working, whether or not you should enroll in Medicare depends in part on what other coverage is available to you. In general, if you have a group plan and the cost of the group plan would be less than your cost on Medicare part B and a supplement or Medicare Advantage plan, then you should probably stay on the group plan. If the group plan is more expensive than being on Medicare part B and a supplement or Medicare Advantage plan, then you would probably opt to take part B and go on Medicare. No matter what your circumstances most people would go on part A because if you've worked and have enough credits it would be premium free. Other issues to consider would be choice of doctors and benefits. For details on your specific situation, don't hesitate to reach me directly at 239-848-8893.
They can delay taking Medicare, I go over what is financially beneficial for the client, sometimes it is cheaper for the client to enroll in Medicare, but they're not obligated to as through the workplace, this is considered " Creditable Coverage" and will not be penalized through the government for not enrolling.
If you become Medicare Eligible while still working and receive health insurance through your job, you have a choice to stick with either your employers coverage or to enroll in Medicare. When making this decision it comes down to cost, which is more beneficial to you, your employers coverage or Medicare. If you decide to stay with your employers health plan, your employers plan is considered “creditable coverage”. As long as you have had creditable coverage since becoming Medicare eligible, you have a three month Special Enrollment Period when you lose your employers coverage to enroll in Medicare without any penalties.
You need to enroll in part A regardless if you still working or not after turning 65, however for part B, if you current employer offer a health insurance that is creditable as good as Medicare then you don’t need to enroll into the letter B and can be delayed without incurring penalties in future.
If you are still working, have creditable employer health and prescription insurance, meaning it is as least as good as Medicare (HR should know this), then enroll in Medicare Part A ONLY. It has zero cost, provided you've worked 10 years and paid into Medicare.
Approx. 3 months before you are ready to retire and selected an end date of employment (end of month is easier), enroll in Medicare Part B (for 1st of month following this end date). After receiving your revised Medicare Card showing Part A & B dates, have a local agent assist in educating and selecting the appropriate plan(s) to begin without a gap in coverage.
If the employer has over 20 full time employees and the coverage is creditable and meaning it meets the standard coverage model of Medicare, and the employee is still employed full time they may delay Part B. Good rule of thumb is to check with their HR to ensure they still have coverage through their Group Plan. If the Employer wants them off the plan it's time to explore other options and take Medicare.. I always tell people to compare benefits and coverages with what you're paying now along with all dr's and prescriptions
It depends on the size of the employer. If there are 20 or more employees, they can usually delay Part B without a penalty. But it's always smart to double-check the details.
In the event they have employer coverage, they should enroll and compare their Medicare Advantage option with their employer coverage to determine which is more beneficial.
As long as the senior has an employee sponsored health insurance plan they can delay going on Medicare. If a senior is employed but does not have health insurance a penalty is involved for delaying enrollment.
The answer would rely on the senior's place of employment. If the company the senior works for is less than 20 employees on payroll, Medicare would be primary and the senior should enroll in Medicare. However, if the company has over 20 employees, than the senior could delay it.
This is a complex question, and one that I would recommend a personalized consultation with a trusted local agent/broker. Every situation is different, and unique. I have had many clients who have opted to delay as well as many who have opted to enroll in Medicare while continuing to work.
Call me to discuss. You should apply for Medicare Part A but possibly hold off on Part B for time being, however again, Medicare is NOT a one size fits all product and really depends on several factors