KFOR-TV: Still Working at 65? Here’s How to Handle Medicare
If you’re still employed at 65, your Medicare decisions matter more than you think.
Watch Segment on KFOR-TV
Turning 65 used to mean one thing: signing up for Medicare and stepping into retirement. But today, many Americans are working longer, and often have solid health coverage through their employer. That raises an important question: do you still need to enroll in Medicare at 65, or can you wait?
The answer depends largely on your work situation and the size of your employer.
If you’re still working
If you or your spouse is still working past age 65 and you have health insurance through that job, you may be able to delay enrolling in Medicare without facing a late enrollment penalty—but the details matter.
First, a quick refresher: Original Medicare has two main parts. Part A covers hospital care and is premium-free for most people. Part B covers doctor visits, lab tests, and outpatient services and carries a monthly premium of $202.90 in 2026. Higher-income individuals (over $109,000) and couples (over $218,000) pay more.
If you’re already receiving Social Security, you’ll automatically be enrolled in Parts A and B when you turn 65. Your Medicare card will arrive in the mail, along with instructions on how to decline Part B if you have qualifying employer coverage.
Before making any decisions, talk with your benefits manager or HR department to understand how your current insurance works with Medicare. In many cases, enrolling in Part A makes sense since it’s free—but keep in mind that doing so will prevent you from contributing to a Health Savings Account.
Whether you should enroll in Part B depends mainly on your employer’s size.
Small employer
If your employer has fewer than 20 employees, Medicare becomes your primary insurance. In this case, you should enroll in Part B during your Initial Enrollment Period—a seven-month window that includes the three months before your 65th birthday, your birthday month, and the three months after.
If you’re not already receiving Social Security, you’ll need to apply for Medicare yourself. You can do this online at ssa.gov/medicare/sign-up, by phone at 800-772-1213, or in person at your local Social Security office.
Missing your Initial Enrollment Period can be costly. You’ll have to wait for the General Enrollment Period (January 1 through March 31), with coverage starting the following month. On top of that, your Part B premium will increase by 10 percent for each full year you delayed enrollment. Signing up on time helps you avoid both coverage gaps and lifelong penalties.
Large employer
If your employer has 20 or more employees, your group health plan typically remains your primary insurance while you’re actively working. In this case, you generally don’t need to enroll in Part B at 65 if your coverage is adequate. If you do enroll, Medicare will act as secondary coverage.
Once your job or employer coverage ends, you’ll have an eight-month Special Enrollment Period to sign up for Part B without penalty.
Check drug coverage
It’s also important to review your prescription drug coverage. Ask your benefits manager whether your employer’s plan is considered “creditable.” If it is, you can delay enrolling in a Medicare Part D plan without penalty. If it’s not, you should enroll in Part D during your Initial Enrollment Period to avoid a penalty—typically 1 percent of the national average premium for each month you delay.
You can compare Part D plans at medicare.gov/plan-compare.
Need help?
If you’re unsure about your situation, free help is available. You can contact the Oklahoma State Health Insurance Counseling Program at 800-763-2828 or call the Medicare Rights Center helpline at 800-333-4114 for guidance and answers to your questions.