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?

Question

John Stagner · Accepted Answer

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.

Norman Smith · Answer

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. 
If in FL or PA, I can help you.

Tony Capraro III · Answer

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!

William Lawler · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/m-still-working-at-67-and-i-dont-know-if-i-need-part-b-why-is-something-so-basic-so-hard-to-figure-out#william-lawler

Tasha Riggs · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/m-still-working-at-67-and-i-dont-know-if-i-need-part-b-why-is-something-so-basic-so-hard-to-figure-out#tasha-riggs

Andrew Zurbuch, MBA · Answer

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.

Pamela Camey · Answer

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.

Andrew Bennett · Answer

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.

Rodney Powell · Answer

It usually comes down to whether you have "creditable coverage." That means:

•  You’re actively working for a company with 20 or more employees.

•  Your group health insurance is as good as, or better than, Medicare.

If so, you have options — you can stay with your group plan or move to Medicare — whatever works best for your needs.

Christopher Soto · Answer

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.

Answered by Christopher Soto on June 4, 2025

Broker Licensed in CA, AL, AZ & 29 other states

Answered by Christopher Soto Medicare Insurance Agent

Steven Bleicher · Answer

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.

Timothy Brown · Answer

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.

Answered by Timothy Brown on April 13, 2025

Broker Licensed in PA, CT, DE & 15 other states

Answered by Timothy Brown Medicare Insurance Agent

Barbara Barnes, CMIP® · Answer

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.

Michael Pyers · Answer

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.

Mary Salmon · Answer

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.

Answered by Mary Salmon on April 9, 2025

Broker Licensed in TX & OK

Answered by Mary Salmon Medicare Insurance Agent

Daintee Hurst Dietz · Answer

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.

Answered by Daintee Hurst Dietz on June 21, 2025

Agent Licensed in TX

Answered by Daintee Hurst Dietz Medicare Insurance Agent

Deb Haley · Answer

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.

Answered by Deb Haley on June 2, 2025

Broker Licensed in MA, CT, FL & 10 other states

Answered by Deb Haley Medicare Insurance Agent

Bill Zeky · Answer

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.

Answered by Bill Zeky on May 19, 2025

Broker Licensed in PA, AL, CO & 10 other states

Answered by Bill Zeky Medicare Insurance Agent

Jeremy Purse · Answer

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.

Answered by Jeremy Purse on May 13, 2025

Broker Licensed in CA, AL, AZ & 5 other states

Answered by Jeremy Purse Medicare Insurance Agent

Jennifer Stark · Answer

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.

Answered by Jennifer Stark on April 7, 2025

Broker Licensed in WI, CO & FL

Answered by Jennifer Stark Medicare Insurance Agent

Garrett Ball · Answer

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).

Answered by Garrett Ball on April 16, 2025

Broker Licensed in NC, AL, AR & 38 other states

Answered by Garrett Ball Medicare Insurance Agent

Fred Manas · Answer

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.

Vachik Chakhbazian · Answer

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.

Marcie Barnes · Answer

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 9403000312 Marcie Barnes

Answered by Marcie Barnes on April 11, 2025

Agent Licensed in TX, AK, AL & 48 other states

Answered by Marcie Barnes Medicare Insurance Agent

Suzanne Lamperti · Answer

You need to sign up for Part B when you retire. You will get a permanent fine if you don't.  Then you will need a Medicare Supplement.

Deborah Webster · Answer

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.

Answered by Deborah Webster on July 9, 2025

Broker Licensed in Ia & SC

Answered by Deborah Webster Medicare Insurance Agent

Charles Borg · Answer

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.

Tony Merwin · Answer

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.

Daniel Young · Answer

You do not need part B until you lose your employer's health plan.  No need to incur the part B premium until necessary.

Lorrie Scully · Answer

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.

Answered by Lorrie Scully on April 28, 2025

Broker Licensed in IA, CO, IL, NE & SD

Answered by Lorrie Scully Medicare Insurance Agent

Brian MacInnis · Answer

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.

Answered by Brian MacInnis on June 19, 2025

Agent Licensed in PA, DE, MD & VA

Answered by Brian MacInnis Medicare Insurance Agent

Eric Knipp · Answer

If you currently have health insurance through your employer you do not need Part B even if you are drawing social security benefits while working.

Ola Clark · Answer

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.

Answered by Ola Clark on July 29, 2025

Agent Licensed in MS & TN

Answered by Ola Clark Medicare Insurance Agent

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?

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