When to Sign Up for Medicare If You’re Still Working at 65

Turning 65 is a significant milestone, not just for making another trip around the sun but also for unlocking Medicare eligibility. As the federal health program for more than 68.5 million Americans, Medicare is a vital component of retirement planning.

Enrolling in Medicare is a no-brainer if you don’t have other health insurance. But what if you’re still working or covered under a spouse’s plan? Do you know when to sign up for Medicare if you’re still working at 65? Should you? Let’s break it down.

Can You Sign Up for Medicare If You’re Still Working?

Yes. If you’ve paid Medicare taxes for at least 10 years, you’ll be eligible for premium-free Part A (Hospital), even if you’re employed. Many people enroll in Part A at 65 because it’s free and can supplement employer coverage.

However, you may delay enrolling in Medicare Part A if:

1. You must pay a premium: Compare the costs and benefits of your employer plan versus Medicare to determine which makes the most sense for you.

2. You contribute to a Health Savings Account (HSA): Once enrolled in any part of Medicare, you can no longer contribute to an HSA.

Do You Need to Sign Up for Medicare If You’re Still Working?

Whether you must sign up for Medicare while still working will largely depend on the size of your employer, among other factors.

1. If your employer has 20 or more employees, you can delay Part B without a penalty and use your employer’s coverage as your primary. Most people enroll in premium-free Part A but skip Part B to circumvent paying the premium.

2. If your employer has fewer than 20 employees, consider signing up for Medicare Parts A and B, making your employer’s coverage secondary. Failure to enroll on time may result in gaps in coverage and penalties.

Can You Have Medicare and Employer Coverage?

Yes. Having both is called dual coverage. How the plans work together depends on the type of Medicare coverage and the employer’s size.

Understanding the Relationship Between Medicare and Employer Coverage

The employer’s coverage pays first when it has 20 or more employees. Medicare helps by paying the remaining costs.

Medicare pays first when the employer has fewer than 20 employees, making the employer’s coverage secondary. In this case, consider enrolling in full Medicare to avoid gaps.

Additional Coverage Considerations

In addition to Medicare Parts A and B, other coverages can bolster your coverage or help bridge gaps:

1. Medicare Part D (Prescription) can be delayed without penalty if your employer provides creditable coverage.

2. Medicare Part C (Medicare Advantage) is an all-in-one alternative to original Medicare. Part C offers the benefits of Parts A and B, along with additional services, including prescription, dental, vision, and hearing care. Using Part C with an employer’s plan can lead to overlaps or conflicts of coverage.

3. Medicare Supplement, also known as Medigap, helps cover deductibles, coinsurance, and other out-of-pocket expenses. However, Medigap only works with Medicare Parts A and B, not your employer’s coverage. In other words, you can’t use Medigap if Medicare isn’t your primary insurance. Learn more about Medicare Supplement Insurance.

How Much Does Medicare Cost If You’re Still Working?

Using Medicare while still working can save you money, but these services are not free. Be sure to check Medicare.gov for the most recent pricing information from Medicare.

How Much Does Medicare Part A (Hospital Insurance) Cost If You’re Working?

If you or your spouse has a minimum of 10 years of Medicare-taxed employment, you may be eligible for premium-free Part A coverage. If not, Part A premiums can range from $258 up to $518 monthly with a $1,676 deductible per hospital stay.

How Much Does Medicare Part B (Medical Insurance) Cost If You’re Working?

In 2025, Part B has a standard monthly premium of $185, which is subject to income-based adjustments. Once you meet the annual deductible of $257, you will pay about 20% of approved services.

How Much Does Medicare Part D (Drug Coverage) Cost If You’re Working?

While your actual premium may vary based on your plan and income level, the Medicare Part D national base premium is $36.78 a month.

Are There Additional Assistance Programs to Help with Premiums?

If you’re working and have limited income or resources, you may be eligible for assistance through a few different programs:

• The Qualified Medicare Beneficiary program helps cover Part A and Part B premiums, deductibles, coinsurance, and copayments.

• The Specified Low-Income Medicare Beneficiary program helps pay for Part B premiums. You must have Part A and Part B to qualify for this program.

• Qualifying Individual programs help pay for Part B premiums.

• The Qualified Disabled and Working Individual program helps pay for Part A premiums only for specific individuals with disabilities.

• The Extra Help (Low-Income Subsidy) program helps reduce Part D premiums, deductibles, and copays and may eliminate late-enrollment penalties.

Are There Penalties for Delaying Enrollment?

Failing to enroll in Medicare during the Initial Enrollment Period can result in enrollment penalties. Unlike one-time fees, enrollment penalties are added to your monthly premium for as long as you have the coverage, resulting in a lifetime of late enrollment penalties. The penalty increases the longer you wait to sign up, based on the amount of time you go without coverage.

• Part B Penalty: A 10% increase for every 12 months you delay.

• Part D Penalty: A 1% increase for each month you go without creditable drug coverage.

How to Sign Up for Medicare

The first step to signing up for Medicare is to determine if your employer’s plan qualifies as credible coverage. This can dictate whether you should enroll immediately or delay certain Medicare parts.

After researching and deciding which parts to enroll in, the final step is to complete the enrollment process, which you can do:

1. Online at ssa.gov/medicare.

2. By phone at 1-800-772-1213.

3. In person at your local Social Security office.

Enrolling in Medicare at the Right Time

When it comes to Medicare enrollment, there are three key dates you should know:

1. Initial Enrollment Period: Three months before and after your 65th birthday month.

2. Special Enrollment Period: If you’re coming off employer coverage.

3. General Enrollment Period: January 1–March 31 each year. Coverage starts July 1. Late penalties may apply if you delay enrollment without creditable coverage.

Once you have enrolled, you will receive your Medicare card in the mail and can begin using coverage when it starts.

Still Working at 65? Remember These Key Takeaways

Here are a few key takeaways to remember if you’re still working at 65:

• You can enroll in Medicare while still working.
• Employer size matters. If your employer has fewer than 20 employees, Medicare will likely be your primary coverage.
• Medicare Part A is often free, but Parts B and D have costs, so it’s critical to enroll properly.
• Medicare enrollment penalties are real, so ensure you confirm your employer’s coverage is creditable.
• Assistance is available through various programs.

Medicare can be a powerful benefit, but navigating it alone can create more confusion than clarity. The right guidance can help simplify your choices and empower you to make more confident decisions that align with your health, financial goals, and future retirement plans.

We’re here for you!

Bankers Life is here to help customers with their financial and insurance needs so please visit us at BankersLife.com to learn more.

Bankers Life and Casualty Company and its licensed agents are not affiliated with the U.S. government or the federal Medicare program.

Bankers Life Securities, Inc., Bankers Life Advisory Services, Inc., and their representatives do not provide legal or tax advice. Each individual should seek specific advice from their own tax or legal advisors.

This material is for general information only and is not intended to provide specific advice or recommendations for any individual. There is no assurance that the views or strategies discussed are suitable for all investors. To determine which investment(s) may be appropriate for you, please consult your financial professional prior to investing.

Bankers Life is the marketing brand of various affiliated companies of CNO Financial Group including, Bankers Life and Casualty Company, Bankers Life Securities, Inc., and Bankers Life Advisory Services, Inc. Non-affiliated insurance products are offered through Bankers Life Securities General Agency, Inc., (dba BL General Insurance Agency, Inc., AK, AL, CA, NV, PA).

Securities and variable annuities offered through Bankers Life Securities, Inc. Member, FINRA/SIPC (dba BL Securities Inc., AL, GA, IA, IL, MI, NV, PA). Advisory products and services offered by Bankers Life Advisory Services, Inc. SEC Registered Investment Adviser (dba BL Advisory Services, Inc., AL, GA, IA, MT, NV, PA).

Investing involves risks including possible loss of principal. No investment strategy or risk management technique can guarantee return or eliminate risk.

Investments are: Not Guaranteed—Involve Risk—May Lose Value.