Medicare While Working Past 65

Most Americans become eligible for Medicare when they turn 65. If you are still employed at that time and are not retired, you may want to stay on your employer’s healthcare coverage rather than opting to sign up for Medicare. But it’s important to note that your health care coverage doesn’t have to be an “either-or” situation.

If you’ve worked for at least ten years (40 quarters) at one or more jobs where an employer has paid into your Medicare benefits, you qualify for Medicare when you turn 65. Automatic enrollment in Medicare Part A is highly likely if you’ve been receiving social security benefits for the four months leading up to your 65th birthday. But if you’re still actively working, chances are you haven’t started taking social security benefits, so keep reading.

What if I’m still working?

Although many of us look forward to punching the clock for the last time, you certainly don’t have to retire if you don’t want to. However, depending on your situation, you can keep your employer plan and use Medicare as well.

If your employer offers healthcare coverage and you work for a company smaller than 20 employees, Medicare could help pay for some of the costs that are not covered through the group health plan. Or you could use Medicare as the primary payer before your employer’s health insurance, which could help cut some of your costs.

If you work with a large employer (more than 20 employees), you may be able to delay signing up for Medicare. You’ll want to discuss your group health insurance plan with your human resources representative to determine if you’ll have enough coverage or the right kind of coverage that will allow you to forgo Medicare at this time.

If you entered the workforce at a later stage in life and don’t have the required 40 quarters of employment history, you will probably have to pay a premium to get Medicare Part A. Check with your employer’s health plan to see if you have coverage that allows you to delay signing up for part A.

Benefits of Medicare Part A:

This provides hospital coverage, including inpatient care, inpatient mental health services, hospice care, limited home healthcare, limited stays in a skilled nursing facility, and inpatient rehabilitation services. 

Benefits of Medicare Part B:

This part covers medical insurance, including doctor appointments, durable medical equipment, occupational or physical therapy, lab work, vaccinations, and much more. This coverage could impact your employer coverage. Medicare Part B also requires paying a premium where Part A is free if you qualify.

Enrollment Periods

It’s also important to keep in mind that if you put off signing up for Medicare when you are 65, you may have to pay a penalty for delaying enrollment. As you near 65, you’ll enter what is known as the Initial Enrollment Period. This is a seven-month span: Three months before your birthday month, your birthday month, and the following three months.

If you delay signing up for Medicare because you already have enough coverage through your work, you don’t have to do anything. When you are ready to finally call it quits, you’ll be able to sign up for Medicare during a Special Enrollment Period (SEP).

The SEP is in place for major life changes. Retiring or ending group coverage is certainly a life change, along with moving, being involved in a life-changing accident, or starting to suffer from a major illness or disease. This enrollment period lasts for a period of eight months, so you have time to research the best options before enrolling in Part A, Part B, and Advantage or supplemental plans.

Work With The Experts 

Are you trying to determine if you should sign up for Medicare while you are still employed? It’s a good idea to start doing your research before you turn 65, so you know what your best options are. In addition to the employer’s group plan and Original Medicare (Part A and Part B), you may want to consider Medicare Advantage plans or Medicare Supplement plans.

Contact our team of Medicare experts at Guided Medicare. We will help answer your questions and make sure you have the details you need to make an informed decision about your healthcare coverage.


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