I'm still working at 67, and I don't know if I need Part B. Why is something so basic so hard to figure out?
Answered by 41 licensed agents
Answering the first question first: it’s hard to figure out because the government wrote it! They don’t really understand how to make things simple.…
Here’s the quick rule about employer insurance after age 65: if your employer has 20 or more employees and you are covered by the employer’s insurance and still working, you can delay part B as long as you want with no concern about having a penalty later. The moment that you stop working for that employer or discontinue that insurance, that’s the time that you need to enroll into Medicare part B in order to avoid a penalty.
I always advise my clients to compare the costs and coverage of the employer plan versus Medicare so they can make an informed decision.
This is why people need to bring an agent into play. A good agent will walk you through you total expenditures of keeping your current employer provided healthcare and options, against what you could attain should you decide to drop their coverage and obtain your choice of Medicare.
Now the smart thing was you signed in for your Part A as a backup to your existing coverage. It’s what you put money into your whole working career, so take it, it costs you zero.
Now depending on coverage and financial considerations, you simply need to do a total cost comparison. But keep in mind the government dropped the “F” plan after 1/1/2020, and your best option is a “G” now. How long before they drop that and make the “N” plan the best option for you? So you may want to consider that in your planning as well.
It seems hard but when you know the specifics you can make the right decision for you!
If you work for a company with 20 or more employees you can stay on that work plan until you retire and then get Part B! Work with someone like me-who works with Medicare Planning every day for clients! We give great information so folks can make good decisions!
You should compare & contrast your current health insurance coverage to enrolling in Medicare Part B & then picking a Medicare Advantage plan for comprehensive coverage. Medicare Insurance is not easy to figure out. You may find that Medicare Advantage coverage is the way to go for at least 2025 &/Or 2026. Please call a Broker for assistance.
Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
You may be required to get Medicare Part B even when you are working. There are situations in which you must obtain part B when you turn 65.
1) Your employer has less that 20 employees. Medicare becomes the primary payer, and you may be required to enroll in Medicare Part A and Part B, Your employer's health plan becomes the secondary coverage. Employer Health group plans may not be able to provide you the same level of coverage as Medicare.
2) Employers with 20 or more employees, your employer's group health plan is considered primary payer. This means you can generally delay enrolling in Part B until after you lose that coverage.
3) If you have health insurance coverage through a spouse's employer, you may also delay enrolling in Part B until you lose that coverage.
Coverage based on current employment does not include COBRA, retiree health coverage, VA benefits or individual coverage through the health insurance Marketplace.
It's not hard. If you have good insurance from your company that you are satisfied with then stay there. IF your coverage is too expensive or not good enough then move to Medicare.
What's "too expensive"? The least expensive thing in Medicare is going to be Medicare Advantage plans with a $0 premium. Keep in mind you will still have to pay your Part B premium which is $185 here in 2025. That's the "low end" of Medicare coverage.
The high end is the Part B premium ($185), Plus a G supplement (ballpark $150...prices can vary widely around the nation), a drug plan (PDP=Prescription Drug Plan) (ballpark $20...again prices can vary widely), and a dental plan (ballpark $40). That gives you total monthly costs of $395.
The high end is very good coverage with very little out of pocket when you get care each year. It's the "Cadillac Plan" so to speak.
If your company plan is more than $395 for you then you should really consider Medicare. IF you have a spouse that relies on your company plan for good coverage at a reasonable monthly cost you may need to stay where you are at.
If you're still working and have credible insurance as good as Medicare or better than you're not obligated to enroll into Part B. If this is accomplished than you will not be hit with a late enrollment penalty. Medicare is too complex, when you navigate Medicare, it's best to work with a licensed professional who works in the industry full time.
Simply stated, if you feel that your employer's plan is working for you, then there is no need to even think about getting Part B yet. But when you retire or are separated from your firm, three months before that is when you'll have to do some investigating to determine the differences between the health insurance you had at your workplace vs. the usually better Medicare coverage.
The only thing to do is the comparison between the Medigap (or a Med. Supplement) and the Medicare Advantage plan. The latter is free of premium (as it is govt-subsidized) but has a fairly steep deductible (around $3,000.00/year), while the Supplement has no high deductibles but DOES have a monthly premium. In either case, you will have to pay for Part B's monthly premium (this year, the least amount is $185.00/month) and if you picked a Medigap, there also is a much smaller premium usually for the Part D "Stand-Alone" Prescription Drug plan.
Signing up for Medicare Part B is not mandatory or necessary as long as the employee is currently enrolled in their group employer plan which is considered creditable coverage. As a result, you will be exempt you from a late enrollment penalty should you decided to enroll in Medicare Part B past the age of 65, however there's one exception: Signing up for Medicare Part B will be required if the employer has less than 20 employees.
If you are employed in a group of under 20 people, or if your employer coverage is not as good as Medicare, then you must sign up for Medicare to avoid any potential penalties.
It’s probably hard because you’re asking people who should know, but they don’t know.
If your employer has less than 20 employees, Medicare will be your PRIMARY insurance once you are eligible. That means that your group benefits will pay secondary to Medicare. This means that you need full Medicare coverage - Parts A & B or you will have an 80% hole in your coverage. Often, in this case, it makes sense to use your Medicare benefits and eliminate your group plan for either a Medicare Supplement plan or a Medicare Advantage plan. An exception to this is if your employer is paying for your benefits plan 100% (you are paying nothing for it) or if you are using expensive medications. Either way, you should speak with a Medicare insurance agent to evaluate everything.
If your employer has more than 20 employees, your group benefits plan will be primary and Medicare will be SECONDARY. In this case you may not need your Medicare benefits and you may choose to defer Part A and/or Part B until you lose your group benefits, usually at retirement. Again, though, it is important to speak with a Medicare insurance agent to be sure you are doing this correctly, especially if you have a Health Savings Account or if you are paying a very large premium for your group health plan.
If you are still working for an employer with at least 20 employees and have employer group health insurance, you can postpone part B. I recommend that you get part a while still employed and then enroll in part B when you retire. It is important to speak with a Medicare specialist to determine if your employer group coverage is considered creditable.
If you are over 65 and still working AND ARE STILL COVERED UNDER YOUR EMPLOYER'S HEALTH INSURANCE and that insurance is considered 'creditable coverage' then you do not need to enroll in Medicare Part B at this time. Creditable coverage means that your employer has over 20 employees and that the insurance coverage is as good as what Medicare offers. It can be confusing to figure this out because there are variations that effect whether you need to pay for Part B or not, things like whether you are eligible for employer insurance which is usually determined by the company based on the number of hours you work. Creditable coverage can also depend on how many employees the company has. If you are going to continue to work and will be covered on the employer plan that meets the criteria above, you DO NOT need to enroll in Part B until about a month prior to the end date of your employer health insurance coverage. You will apply for Part B under a SEP (Special Enrollment Period) called "leaving employer group health plan" and would request Part B to start on the first of the month following your last date of coverage from the company.
Are you still working and on company insurance? Is it creditable? Do you have dependents on your plan? There are many factors as to when and where you transition. Having a trusted Agent in your corner to refer to is very important.
Medicare rules are “one size fits all” — but employers’ insurance rules aren’t. The tricky part is figuring out how your job’s insurance interacts with Medicare. That’s why the answer is different for a 67-year-old at a 3-person law office versus a 67-year-old at IBM. Make sure you have a Medicare Advocate that will help you navigate these complexities.
If you still have employer coverage then you do not necessarily need Part B. However, it is best to sit down and compare your current plan to Medicare and see which would give you the best deal. Factors to consider in the comparison are premium, deductible, and max out of pocket. Once these figures are taken into account then you can make an educated decision on whether to continue employer coverage or to go fully onto Medicare.
As I stated on another questions, many points of confusion are the fault of getting advice from uneducated sources. While family and friends are well intentioned, they're not well trained, annually tested licensed insurance agents. Politely listen to them but then seek out a professional who will fully educate you.
If you are still covered under an Employer Group Health Plan, you can delay your Part B until you retire or lose your health insurance. Once you know your insurance through your employer will be ending, apply for Part B and submit CMS Form L564 to prove to Medicare that you had credible coverage from the time you turned 65. This will help avoid a Part B Late Enrollment Penalty.
Great question! If you are continuing to work past 65 and have creditable coverage through employer insurance, you do not need to enroll into Part B. However, it’s always a good idea to have a Medicare Broker run a side by side comparison for you, because oftentimes Medicare options will beat out employer plans and can save you money!
You will need a part B plan only if you are not under employer coverage that includes a perscription drug plan. When you decide to retire and get off of their group plan, you can apply for part B. Then get on A Medicare advanatge plan that includes a drug plan. Or you cxan chose a Medicare Supplement plan and get a stand along PDP.
You do not need Part B if you are covered by a group/employer plan that is primary to Medicare (if employer has more than 20 employees). You can delay Part B enrollment and add it later, without penalty, through a special enrollment period (https://www.ssa.gov/medicare/sign-up/part-b-only).
It can be a confusing mess of information when deciding what to do with Medicare after age 65. In general, if your company offers qualifying coverage (you should be notified every year if it does), you do not need Part B. It may be wise to review work coverage benefits and compare them to Medicare benefits and costs. What seems like a deal at work might not be when you look under the hood. Many factors will play into when is the best time to take Medicare if you're still working, like: Age of a spouse, IRMAA (Income Related Medicare Adjustment Amount), health, upcoming procedure, knee replacement, etc. Consult an independent broker like Senior Legacy Partner, we can help make the complex simple.
If you're still working at 67, you likely don't need to enroll in Medicare Part B immediately. Medicare Part B is voluntary and you can delay enrollment if you have creditable health insurance coverage through your employment. This is because Medicare Part B is designed to work in coordination with other health plans, and if your employer coverage is strong, you may not need it.
Here's why it can be confusing:
It's not mandatory at 65:
Many people assume Medicare Part B is mandatory at 65, but that's not the case for those who have employer-sponsored health insurance.
Late enrollment penalties:
If you delay enrollment beyond certain periods, you may face late enrollment penalties.
Complexity of employer plans:
Determining whether your employer's health plan is "creditable" (meaning it provides at least the same coverage as Medicare) can be tricky.
Impact on other insurance:
Your decision to enroll in Part B can affect other insurance you might have, like Medigap or COBRA.
To clarify your situation:
Check your Initial Enrollment Period (IEP): This is a 7-month period around your 65th birthday when you can enroll in Medicare.
Talk to your employer: Ask your employer's benefits administrator if your plan is considered creditable and what happens if you sign up for Part B.
Contact Medicare: The Social Security Administration (.gov) can provide guidance on your specific situation.
Consider the costs: Part B has a monthly premium, so weigh the cost against the benefits.
Understand the penalties: Medicare (.gov) can explain the penalties for late enrollment.
you can delay enrolling in Part B and may not need it until you retire. if your employer has fewer than 20 employees, you'll likely need Part B to avoid gaps in coverage.
As long as you have credible coverage through your job you don't need Part B. You may want to explore your options though. Employer coverage is not always the best option if you have high premiums and Deductibles. Feel free to reach out to me to further discuss your options. Marcie Barnes
It is not a requirement for taking part B when you are covered under a group health plan with your employer. Most people will delay B while still working if they are allowed to stay on employer coverage (check with your HR on policy rules). They will take B at a later date when they fully retire and quit working. Ship offices will help with information about this, as well as local agents you may work with to help explain your options for Medicare.
If you’re covered by an accredited plan through your employer, you don,t. Check with your employer or group insurance to make sure that your health plan qualifies.
You must enroll in Part B unless you have qualifying employer insurance and are working. Aside from that it comes down to comparing cost and quality of coverage.
I know that Medicare can be extremely confusing so hopefully this information will help. If you are still working and continue to work, it is OKAY to delay Part B as long as your employer coverage is considered "creditable" coverage. Your HR department will be able to advise you on that. As long as that is the case, then no worries.
Once you know when you are going to retire and leave employer coverage, you will want to apply for Part B 3 months prior to your retirement month. Your HR department will need to fill out an L564 form to prove that you have had creditable coverage. You must submit the L564 form along with your Part B application. This way, you should not incur a Part B Late Enrollment Penalty since you have had creditable coverage.
That's because it's not your field of expertise. I am sure that I would not be proficient in your field of business! Navigating Medicare can be confusing. Find out with your current employee if you need Part B to coordinate with your employee coverage. If you do not need Part B, you can wait until you retire and or lose group coverage. Then you will have a guarantee issue period to enroll in a Medicare Plan. Supplement, Advantage or prescription plan etc...
If you are still receiving Group Health Insurance, you don't need part B. However, Medicare insurance is likely less expensive than Group insurance, and the health insurance benefits, and coverage would be much better.
If you are working for an employer that offers “creditable health insurance” you can delay enrolling in Part B Medicare once you are 65. Your HR dept can advise if your company insurance is creditable. It is very confusing!!
Also the company MUST have 20 or more employees to avoid penalty. If not, then you have to enroll in Medicare Part B to avoid penalty at age 65 as Medicare is primary insurance for people at companies with less than 20 employees.
Once your employment ends you will have a short window to enroll in Part B without penalty.
I'm happy to help you with this question but I would need a little more information. If you are still working and on your employer's health plan, you can delay taking Medicare part B until you retire without incurring any penalties. Some questions I have to be able to best answer your question: Does your employer have at least 20 employees? Is your employer-sponsored health plan less expensive than the cost of Medicare part B? Consider the costs, benefits, and potential penalties associated with both your employer's plan and Medicare Part B. Let me know if I can help :)
If you are still working and have credible coverage, you can delay Part B until you are ready for Medicare. If you currently have a major medical health plan offered through your employer, it would be considered credible coverage. Depending on how much you pay (if any) each month for your employer coverage, pursuing Medicare before you officially retire could make financial sense.
The rules can be tricky because Medicare and employer coverage work together in specific ways. If your job-based insurance is considered creditable, you may not need Part B right now, but always double-check the details so you avoid late penalties later.