Many people keep working past 65. If you or your spouse still have health coverage through a job, you may not need to sign up for every part of Medicare right away. The right answer depends on a few details. This page explains them.
We do not offer every plan available in your area. Currently we represent 8 organizations which offer 60 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Boyer Insurance Services is a licensed, independent insurance agency. We are not connected with or endorsed by the U.S. government, the Centers for Medicare & Medicaid Services (CMS) or the federal Medicare program.
Who Pays First: Medicare or Your Employer Plan?
When you have both Medicare and employer coverage, one pays first (primary) and the other pays second (secondary). The size of the employer matters most.
- Employer with 20 or more employees: the group health plan generally pays first. Many people in this situation delay Part B without a penalty.
- Employer with fewer than 20 employees: Medicare generally pays first. If you do not enroll in Parts A and B, your employer plan may pay very little.
These rules apply to coverage from your own current job or your spouse’s current job. Always confirm with your employer’s benefits administrator how their plan works with Medicare.
Should You Take Part A?
Part A is premium-free for most people, so many people enroll in it at 65 even while working. There is one big exception: Health Savings Accounts.
HSAs and Medicare
Once you are enrolled in any part of Medicare, you can no longer contribute to a Health Savings Account. You can still spend the money already in it.
Keep in mind that when you sign up for Part A after 65, coverage can be backdated up to six months (but not before the month you turned 65). Many people stop HSA contributions about six months before they plan to enroll to avoid a tax issue. A tax professional can help with your specific case.
Delaying Part B
If your coverage comes from current employment, you can usually delay Part B. When that job or coverage ends, you get an eight-month Special Enrollment Period to sign up without a penalty.
Two common surprises:
- COBRA does not count as coverage from current employment. Waiting until COBRA ends to sign up for Part B can lead to a penalty and a gap.
- Retiree coverage also does not count as coverage from current employment.
Drug Coverage While You Work
Your employer should send a notice each year saying whether its drug coverage is “creditable,” meaning it is expected to pay on average at least as much as standard Part D coverage. If it is creditable, you can generally delay Part D without a penalty. Keep these notices.
When You Retire
- Plan your Medicare start date before your employer coverage ends.
- Ask your employer to complete the form showing you had group coverage (Form CMS-L564). You submit it with the Part B application (Form CMS-40B).
- Decide between Original Medicare with a Medicare Supplement and Part D, or a Medicare Advantage plan.
- Remember your Medigap Open Enrollment Period starts when your Part B starts.
For Employers
If you own a small business, how your group plan works with Medicare affects your older employees. We help employers with small business health insurance and employee benefits and can explain these rules to your team.
Talk With Us About Your Situation
Reading about Medicare and employer coverage is a good start. Your own situation is what really matters. If you would like to talk through your options, call us at 310-440-0281 or toll free at (844) 532-9009, or contact us here. We will listen first, answer your questions and explain the choices available to you. There is no obligation to enroll in anything.