Working Past 65 and Medicare: Can You Delay Part B? | Employer Coverage Rules

You may be able to delay Medicare Part B if you are still working and covered by qualifying active employer group health coverage. Whether delaying is safe depends on employer size, whether coverage is based on current employment, whether you have HSA contributions, and when that employer coverage will end.

Key Rules

The 20-employee threshold is the key rule: employers with 20+ workers pay first; employers under 20 mean Medicare is primary
Active employment means actively working — being on COBRA or retiree coverage after retirement does not qualify
The 8-month SEP after coverage ends does not reset if you elect COBRA after leaving employment
Spouse coverage follows the same 20-employee rule — based on your spouse's employer size, not yours