Spouse's Employer Under 20? Don't Delay Part B at 65

No, not safely. When your spouse's employer has fewer than 20 employees, Medicare is primary for you at 65 — regardless of whether your spouse is still actively working. Delaying Part B exposes you to claim denials and a permanent late-enrollment penalty.

Frequently Asked Questions

Does the under-20 rule apply if my spouse is still working?
Yes. Even with your spouse actively employed, if the employer has fewer than 20 employees, Medicare is primary for you. Employer size controls who pays first — not your spouse's employment status.
Can I delay Part B if the employer plan has good benefits?
Usually no. Even if the plan has low premiums or broad benefits, employer size determines who pays primary. With under 20 employees, Medicare pays first. Without Part B enrolled, the employer plan covers very little on most claims.
What should I do if I already delayed Part B in this situation?
Check whether a Special Enrollment Period is still available. If not, you will need the General Enrollment Period (January–March) and will owe a permanent late-enrollment penalty. Confirm your specific options with Social Security and your benefits administrator.