Medicare if you're still working at 65
Four questions decide whether you sign up now or later.
Turning 65 while you're still working, or covered by a working spouse's plan, doesn't automatically mean you need all of Medicare right away. But the rules are unforgiving if you guess wrong, so it's worth working through the questions in order.
1. Is your coverage from current employment?
Only group health coverage based on current work (yours or your spouse's) lets you delay Part B without a penalty. COBRA, retiree coverage and individual or Marketplace plans don't.
2. How many employees does the employer have?
With 20 or more employees, the group plan generally pays first and Medicare second, so delaying Part B is usually safe. With fewer than 20, Medicare pays first: if you don't have Part B, the employer plan may pay very little for Part B services. Always confirm with the plan.
3. Do you or your spouse contribute to an HSA?
You can't contribute to a Health Savings Account once you have any part of Medicare. Premium-free Part A can be backdated up to 6 months (but not before you turned 65) when you apply, so stop contributions 6 months before you sign up. You can keep using money already in the account.
4. How does your employer drug coverage compare?
If your employer's drug coverage is creditable, you can delay Part D without a penalty. Your plan should send you a notice each year saying whether it is.
When you stop working
You have 8 months after your job or your group coverage ends, whichever is first, to sign up for Part B without a penalty, using form CMS-40B with your employer's CMS-L564. Sign up before your coverage ends to avoid a gap. Your 6-month Medigap Open Enrollment Period starts when your Part B does.
Common questions
Usually yes if it's premium-free, since it can act as secondary coverage for hospital stays. The main exception is if you're contributing to an HSA.
Individual or self-purchased coverage isn't group coverage from an employer, so it generally doesn't let you delay Part B without a penalty.
Want help with your own choices?
Every state runs a State Health Insurance Assistance Program (SHIP) with trained counselors who give free, unbiased Medicare help and do not sell plans. Find yours on our Medicare by state pages, or call Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week).
Planning the rest of your coverage in retirement? We can help with life insurance later in life and final expense coverage.
Sources
- Working past 65, Medicare.gov. Checked September 29, 2026.
- How Medicare Works with Other Insurance, Centers for Medicare & Medicaid Services. Checked September 29, 2026.
- When does Medicare coverage start?, Medicare.gov. Checked September 29, 2026.
General information about the federal Medicare program, not advice about your situation. Figures are for 2026 unless stated and change every year; last reviewed September 29, 2026. Quote My Policy is a private company. Not connected with or endorsed by the United States government or the federal Medicare program.
Quote My Policy does not sell Medicare plans on this site. For plan-specific help, contact Medicare at 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048, 24 hours a day, 7 days a week) or your State Health Insurance Assistance Program.