Medicare and Working Past 65

• Many people start thinking about Medicare as they approach age 65.

• More Americans are working past 65:

  • 35.2% of people 65+ were still working in 2023.

  • Expected to rise to 40.5% by 2033.

• Your health coverage options depend on:

  • Whether you’re still working.

  • The size of your employer.

  • If you have coverage through a spouse.

 

Medicare Basics

• Medicare helps cover health costs as you age or if you have certain disabilities.

• Automatic enrollment:

  • Card arrives ~3 months before your 65th birthday (or 25th disability month).

• Medicare Part A (hospital insurance) is usually free.

• Medicare Part B (medical insurance) requires sign-up and a premium.

  • Delaying enrollment in Part B or Part D (prescription drugs) can cause late penalties.

 

Medicare Part B Enrollment Rules

• If employer has 20+ employees:

  • You may delay Part B and keep employer coverage.

  • Or combine both, using Medicare as secondary.

• If employer has fewer than 20 employees:

  • Must enroll in Parts A and B at 65.

  • Medicare becomes your primary insurance.

• If covered through spouse’s employer:

  • Rules depend on the employer’s plan.

• Late enrollment penalty:

  • Added to your monthly premium.

  • Lasts as long as you have Medicare.

 

Medicare Part D (Prescription Drug Coverage)

• You can delay Part D if your employer’s drug plan is creditable coverage (covers at least as much as Medicare).

• Employers send a Notice of Creditable Coverage each September.

• If coverage ends, you enter a Special Enrollment Period to sign up without penalty.

 

Enrollment Options to Avoid Penalties

• After job or group coverage ends, you have a Special Enrollment Period for:

  • Original Medicare Part B.

  • Medicare Advantage.

  • Medicare Supplement plans.

• Other Special Enrollment Periods may apply if:

  • You move.

  • You face an exceptional situation (e.g., natural disaster).

• Missing this window means waiting for Open Enrollment — risking gaps in coverage.

 

Health Savings Accounts (HSAs) and Medicare

• Once enrolled in Medicare, you cannot contribute to your HSA anymore.

  • Doing so may cause tax penalties.

• You can still use HSA funds for:

  • Medicare premiums.

  • Copays and deductibles.

  • Prescription drugs.

 

Key Takeaway

• Working past 65 gives you choices:

  • Stay on employer insurance.

  • Move to Medicare.

  • Combine both.

• Knowing your options helps you avoid penalties and stay protected.

​

​

Consider speaking with an advisor from Elkin Insurance to make the best choice for your situation.