If you or your spouse are planning to work after turning 65, you’re probably wondering how working past 65 and Medicare go together. One of the most important first questions to ask is if your employer requires you to enroll in Medicare Parts A and B (Original Medicare) when you turn 65.* Your human resources representative can help you figure that out.
But there are other factors to think about that can help you minimize expenses and maximize coverage. To help guide you through your Medicare options, here are some other key questions to consider.
What you need to know about working past 65
If you’re working past 65, whether and when you should enroll in Medicare depends on your employer’s size, your current coverage and if you’re receiving Social Security benefits. Signing up at the right time can help you avoid coverage gaps and lifetime late enrollment penalties.
Do you get your health insurance through a job with a small business?
If you or your spouse are working past 65, the size of the company that provides your insurance matters.
Let’s say your spouse has been working for a small business for the last 10 years and both of you receive your health coverage through their employer. Even if your spouse isn’t considering retirement, the size of their employer is an important factor for you when you need to enroll in Medicare.
That’s because companies with 19 or fewer employees can require you to enroll in Medicare Parts A and B when you turn 65* to continue receiving coverage through the employer.
Learn how to enroll in different plan types so you can choose the method that works best for you
Note that if you don’t apply for Medicare, you could have a gap in your health coverage.
Companies with 20 or more employees are required to continue offering health insurance to current workers and their spouses who are 65 or older. If you’re insured under a plan from a company of that size, you have the option to enroll in a Medicare plan and decline your group plan, but the employer can’t force this decision.
Ready to enroll? Shop Medicare plans near you to see prices and availability
What if you get a payment from your employer to buy your own health insurance?
Now, let’s say the company your spouse works for gives them a certain amount to help pay for the health plan that covers you both. That can also affect when you may decide to enroll in Medicare.
If you purchase private health insurance through an employer payment, it’s a smart idea to do some research. In some cases, private insurers may reduce the amount they pay for services once you’re eligible for Medicare. Medicare may also not work with your insurance, and once you sign up for Parts A and B, Medicare will pay your medical bills first, before your insurance. Bottom line: Talk to your health insurance company about whether you need to sign up for Medicare when you turn 65.
Are you or your spouse still working but don’t have any type of health insurance?
If you don’t currently have coverage, you should sign up for Medicare Parts A and B during your Medicare Initial Enrollment Period (IEP). This is a seven-month window that includes the three months before, the month of and the three months after you turn 65. Doing so can help shield you from higher-than-expected medical costs. Signing up for Medicare on time is also important. You may have to pay Medicare late enrollment penalties if you decide to postpone your Medicare enrollment.
Learn how to avoid Medicare penalties
Need help paying for Medicare costs? There are financial assistance programs available to those who qualify. Read more about those programs in the article “Do I qualify for financial assistance with Medicare?”
Do you have COBRA coverage but haven’t signed up for Medicare yet?
If you're enrolled in the Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage, your plan may only pay for a small part of your medical costs once you become eligible for Medicare. To help you avoid unexpected bills, late enrollment penalties and gaps in coverage, sign up for Medicare Parts A and B when you turn 65*.
Keep in mind that once you are enrolled in Medicare coverage, your COBRA will probably end. Read “Leaving your job after 65? Taking these 3 actions in time can prevent gaps in your coverage” to learn how COBRA works with Medicare.
Did you start receiving your Social Security or railroad retirement benefits before you turned 65?
Let’s say you chose to start receiving your Social Security benefits at age 62. The decision of when you take Social Security can affect your Medicare enrollment.
Why? Because if you’re already receiving Social Security or railroad benefits, you’ll be automatically enrolled in Medicare Parts A and B when you turn 65. You can choose to opt out of Medicare Part B, but you’ll likely be penalized and have to pay a higher Medicare premium if you decide to enroll later.
If you aren’t collecting benefits when you turn 65, you should plan to sign up for Medicare on your own. You can enroll during your Medicare IEP. If you don’t sign up for Medicare during your IEP, you can do so during the general enrollment period, which happens each year from January 1 to March 31. However, you may have to pay a lifetime late enrollment penalty.
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Medicare enrollment periods
Here are a few important things to remember about Medicare enrollment periods:
Medicare Initial Enrollment Period (IEP)
If you want to enroll in a Medicare plan, you have a seven month window that surrounds your 65th birthday called the Initial Enrollment Period (IEP).
It includes:
- Three months before the month you turn 65
- Includes the month you turn 65
- Three months after the month you turn 65
For example, this means that if you turn 65 on July 2026, your IEP timeline to sign up will be from April 1, 2026 – October 31, 2026. This means that your IEP window to enroll in a Medicare plan is dependent on your 65th birthday month.
Medicare Special Enrollment Period (SEP)
If you’re working past 65 and can delay taking your Medicare benefits, your next chance to enroll is:
- During Medicare’s Special Enrollment Period (SEP). This two-month period begins the month you leave your job and ends two months later.
- If you want to join a Medicare Advantage (MA) plan you’ll need to sign up within two months after your employer coverage ends.
- This is also true if you want to join a stand-alone prescription drug plan.
It’s important to understand the different Medicare enrollment periods to make the most of your benefits.
Compare Medicare plan options. Not sure when you can sign up for Medicare? Read “Unpacking Medicare: What you need to know about Medicare enrollment periods (and when you can change your plan).”
Turning 65 often goes hand in hand with enrolling in Medicare. But if you’re working past 65 and are thinking about Medicare, you have a few additional things to consider;
- Whether your employer coverage allows or requires enrollment in Medicare
- When you should sign up for Medicare if you’re still working
- How enrolling (or delaying enrollment) could affect your costs
- How Medicare would coordinate with your current coverage
- Which coverage option best fits your health needs and budget
Be sure to speak with your human resources representative and a licensed agent so you fully understand your options before making a decision.
To talk with a licensed agent about your Medicare options, call:
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