Do I need Medicare if I am still working after 65?

If your employer has 20 or more employees, you can safely delay Part B while actively working. If your employer has fewer than 20 employees, Medicare is the primary payer at 65 and you should enroll in Part B.

What happens to Medicare when I stop working?

Once you stop working or lose active employer coverage, you have 8 months to enroll in Medicare Part B without a penalty. Missing this Special Enrollment Period window may result in a permanent 10% per year late enrollment penalty.

Which employer size lets me delay Medicare Part B without a penalty?

Only employers with 20 or more employees qualify. With 20 or more, your employer plan pays first and you can safely delay Part B while actively working. With fewer than 20, Medicare pays first at 65 — delaying Part B risks a permanent penalty.

Can I have both Medicare and my employer coverage at the same time?

Yes. With a large employer (20 or more employees), your employer plan pays primary and Medicare pays secondary. Enrolling in both is sometimes done but is not required while actively working for a qualifying employer.

What if I am already collecting Social Security benefits when I turn 65?

If you are already receiving Social Security benefits, you will be automatically enrolled in Medicare Parts A and B when you turn 65. Your Medicare card will arrive before your birthday month. If you have qualifying active employer coverage and want to delay Part B, you must actively decline it when your card arrives.

Do I need Medicare Part A if I keep working past 65?

Enrolling in premium-free Part A is generally recommended even while working. Part A covers hospital care and does not affect your employer plan's primary payer status. However, enrolling in Part A stops HSA contributions — review HSA timing before enrolling.

Working After 65 and Medicare: When to Enroll and When You Can Wait

If you work for an employer with 20+ employees, you can safely delay Medicare Part B. With fewer than 20, Medicare pays first at 65 — delaying Part B risks permanent penalties and coverage gaps.

Frequently Asked Questions

Do I need Medicare if I am still working after 65?: If your employer has 20 or more employees, you can safely delay Part B while actively working. If your employer has fewer than 20 employees, Medicare is the primary payer at 65 and you should enroll in Part B.
What happens to Medicare when I stop working?: Once you stop working or lose active employer coverage, you have 8 months to enroll in Medicare Part B without a penalty. Missing this Special Enrollment Period window may result in a permanent 10% per year late enrollment penalty.
Which employer size lets me delay Medicare Part B without a penalty?: Only employers with 20 or more employees qualify. With 20 or more, your employer plan pays first and you can safely delay Part B while actively working. With fewer than 20, Medicare pays first at 65 — delaying Part B risks a permanent penalty.