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Still Working at 65? What to Know About Delaying Medicare

Turning 65 no longer automatically means stopping work—or starting Medicare. Whether you can delay Medicare without penalties depends on your job-based coverage and a few key rules.

When You Can Safely Delay Medicare

You can usually delay Medicare Part B (and sometimes Part D) without penalty if:

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  • You’re covered by a current employer group health plan (yours or your spouse’s), and
  • That employer has 20 or more employees.

In this situation, your employer plan is typically primary and Medicare is secondary, so you’re not required to enroll in Part B at 65. When your employment or that coverage ends, you’ll get an 8‑month Special Enrollment Period (SEP) to sign up for Part B without a late enrollment penalty.

Many people in this situation still enroll in Part A at 65 because there’s usually no premium. However, if you contribute to a Health Savings Account (HSA), enrolling in any part of Medicare will stop you from making new HSA contributions, and Part A coverage is often retroactive up to six months. That makes timing critical.

When You Should Not Delay Medicare

You generally should not delay Medicare if:

  • Your coverage is through an employer with fewer than 20 employees.
    In that case, Medicare becomes primary, and the employer plan is secondary. If you skip Part A and/or Part B, the employer plan may pay little or nothing for services Medicare would have covered.

  • You have COBRA, a retiree plan, or individual coverage from the marketplace.
    These are not considered active employer coverage for Medicare purposes. Delaying Part B in these situations can trigger lifetime late enrollment penalties and gaps in coverage.

Understanding Late Enrollment Penalties

If you don’t qualify for a Special Enrollment Period and delay Part B:

  • You may pay a higher Part B premium for life.
  • You might have to wait until the General Enrollment Period (January 1–March 31) to sign up, with coverage not starting right away.

Similar penalties can apply to Part D if you go 63 days or more without creditable prescription drug coverage.

How to Decide What to Do

To make a sound choice while still working:

  • Confirm whether your employer coverage is active group coverage and whether the employer has 20 or more employees.
  • Ask your HR or benefits office whether your plan is primary or secondary to Medicare.
  • If you use an HSA, plan ahead for when to stop contributions if you intend to enroll in Medicare.
  • Compare your current costs and coverage to what you’d pay and get with Medicare plus any supplemental coverage.

The core rule: You can often delay Medicare if you have qualifying employer coverage—but not always. Understanding how your job-based insurance interacts with Medicare helps you avoid penalties, gaps, and unnecessary costs while you keep working.