Can I delay Part B if my employer has 20 or more employees?

Yes. If you are actively working and your employer has 20 or more employees, you may wait on Part B. Your employer plan is the primary payer, so Medicare is not needed for most outpatient care while you are actively employed.

Does my employer plan pay first with 20 or more employees?

Yes. For employers with 20 or more employees, the employer plan pays first (primary) and Medicare pays second (secondary) if you choose to enroll. This is called coordination of benefits.

What happens to Part B when I stop working?

You have 8 months from when active employment ends or employer coverage ends — whichever comes first — to enroll in Part B without a penalty. This is your Special Enrollment Period.

Can I have Part A without Part B while I still have employer coverage?

Yes. Most people enroll in premium-free Part A even while delaying Part B. Part A covers hospital care and does not affect your employer plan's primary payer status — and Part A is free for most people who paid Medicare taxes.

What if my employer has exactly 20 employees?

Twenty is the threshold — an employer with exactly 20 employees meets the requirement. Your employer plan is the primary payer and you may wait on Part B without a penalty while you are actively working there.

Does the 20-employee rule apply to coverage through a working spouse?

Yes. If you are covered under a working spouse's employer plan and that employer has 20 or more employees, you may also delay Part B without a penalty while that active employment and coverage continue.

Employer With 20+ Employees and Medicare: When You May Wait on Part B

With 20+ employees your employer plan pays first and you may wait on Part B. When employment ends, use the 8-month SEP to enroll without a penalty.

Frequently Asked Questions

Can I delay Part B if my employer has 20 or more employees?: Yes. If you are actively working and your employer has 20 or more employees, you may wait on Part B. Your employer plan is the primary payer, so Medicare is not needed for most outpatient care while you are actively employed.
Does my employer plan pay first with 20 or more employees?: Yes. For employers with 20 or more employees, the employer plan pays first (primary) and Medicare pays second (secondary) if you choose to enroll. This is called coordination of benefits.
What happens to Part B when I stop working?: You have 8 months from when active employment ends or employer coverage ends — whichever comes first — to enroll in Part B without a penalty. This is your Special Enrollment Period.