Still Working at 65? Do You Need Medicare Part B?
Still working at 65? Learn when you may be able to delay Medicare Part B, what employer coverage matters, and what to check before making a decision.
If you’re still working at 65, you may be able to delay Medicare Part B without a late-enrollment penalty—but it depends on the type of employer coverage you have. Coverage through your own or your spouse’s current job can qualify you for a Special Enrollment Period later, while COBRA and retiree coverage generally do not.
1. Is your coverage based on current employment?
Coverage through your own or your spouse's current job can qualify you to delay Part B and use a Special Enrollment Period later
COBRA, retiree plans, Marketplace plans, and VA coverage do NOT protect your enrollment timing
Get written confirmation from your employer's benefits department
2. How big is the employer?
20+ employees: employer plan usually pays first, Medicare pays second
Fewer than 20 employees: Medicare usually pays first, employer plan pays second
Ask HR directly: "Does our plan pay first after I turn 65, or does Medicare?"
3. Do you have an HSA?
You can't contribute to an HSA once Medicare coverage starts
Medicare Part A can be retroactive up to 6 months — this can trigger HSA contribution problems
Coordinate timing with your employer, HSA administrator, and a tax professional before applying
4. Is your drug coverage creditable?
Ask if your employer/union drug plan is "creditable" (pays as well as Medicare Part D on average)
Save every Notice of Creditable Coverage you receive
Going 63+ days without creditable drug coverage can trigger a Part D late penalty
5. When does your coverage actually end?
You generally get 8 months to enroll in Part B after employment or coverage ends (whichever comes first)
Don't wait until the deadline — apply early to avoid a coverage gap
Track: last day worked, last day of coverage, desired Medicare start date, enrollment deadline
6. Are you considering COBRA or retiree coverage?
COBRA does not extend your 8-month Part B Special Enrollment Period
The clock starts when active employment/coverage ends — even if you elect COBRA
Retiree coverage also doesn't count as "current employment" coverage
7. Is everything in writing?
Keep a folder with:
Written proof coverage is based on current employment
Employer size + who pays first
Notice of Creditable Coverage
Planned employment/coverage end dates
HSA contribution and Medicare start dates
Enrollment confirmations
Benefits contact info
Bottom line
Don't auto-enroll in Part B just because you turned 65 — and don't auto-delay it just because you're still working. Confirm your coverage type, who pays first, drug coverage status, HSA impact, and your employer coverage end date first.
Questions are always welcome — I'm just a call or text away: 435-244-2001.
Get Your Free Medicare Starter Guide to understand the basics, organize what you need and prepare for the decisions ahead.