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Still working at 65

Medicare and employer coverage — how they fit together.

Working past 65 is common. Whether to take Part B now depends on how big your employer is, what coverage you have, and what your spouse needs.

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If your employer has 20+ employees

Your employer coverage is primary and Medicare is secondary. Many people delay Part B (to avoid the premium) and keep employer coverage. You can do this without triggering a Part B late penalty as long as you sign up within 8 months after your employment ends — that is your Special Enrollment Period.

If your employer drug coverage is "creditable," you can also delay Part D — see our late penalty guide.

If your employer has fewer than 20 employees

Medicare becomes primary at 65. You generally should enroll in Part A and Part B during your initial enrollment. Your employer coverage pays second.

If you delay Part B in this situation, you can leave gaps that the employer plan does not fully cover.

What to ask your benefits administrator

  • Is our drug coverage "creditable" for Medicare? Get the letter in writing.
  • How will the plan coordinate with Medicare if I enroll?
  • What happens to my spouse's coverage if I drop out of the employer plan?
  • Are there any retiree-specific options I would qualify for?

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