Turning 65 does not always mean you must enroll in Medicare Part B immediately.
If you or your spouse are still working and you have health coverage through that current job, you may be able to delay Part B without a late enrollment penalty. The key questions are what kind of employer coverage you have and how large the employer is. �
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If the Employer Has 20 or More Employees
For many people age 65 or older, if the employer providing the group health plan has 20 or more employees, the employer plan generally pays first and Medicare pays second.
In that situation, you may be able to wait to enroll in Part B while you or your spouse continue working and you remain covered by the employer group health plan. �
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For example, suppose John is 67 and still works for a company with 100 employees. He is covered by the company’s health plan.
He may be able to delay Part B while he continues working, but he should confirm this with the employer’s benefits administrator because plan rules can vary.
If the Employer Has Fewer Than 20 Employees
If the employer has fewer than 20 employees, Medicare may be the primary payer.
That means your job-based insurance may not fully pay for medical services if you do not have Medicare Part A and Part B. Medicare specifically advises people in this situation to check with the employer when they first become eligible. �
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So having employer insurance does not automatically mean you can safely delay Medicare.
The 8-Month Special Enrollment Period
If you delayed Part B because you had qualifying coverage from current employment, you can generally enroll while you are still working and covered.
After the job or qualifying employer coverage ends, you usually have an 8-month Special Enrollment Period to enroll in Part B without a late enrollment penalty. The period begins after the employment or coverage ends, whichever happens first. �
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Be Careful With COBRA
One of the most important Medicare rules to understand is that COBRA is not treated the same as coverage based on current employment.
Choosing COBRA does not extend your 8-month Part B Special Enrollment Period. Medicare specifically warns people not to wait until COBRA ends before enrolling in Part B. �
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For example, someone who retires at 66 and keeps COBRA for 18 months should not assume that they can safely wait until those 18 months are over to enroll in Part B.
Four Things to Check Before Delaying Part B
Before deciding to delay Medicare Part B, confirm:
Is your health insurance based on your or your spouse’s current employment?
Does the employer have 20 or more employees?
Which plan pays first: Medicare or the employer plan?
When will your 8-month Special Enrollment Period begin if the job or coverage ends?
A useful question to ask your employer’s benefits department is:
“Will my employer health plan remain primary to Medicare after I turn 65?”
Final Takeaway
If you are still working at 65, Medicare enrollment is not one-size-fits-all.
People with qualifying coverage from a current employer may be able to delay Part B, while people working for smaller employers may need Medicare because the employer plan may pay second. �
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And once employment or qualifying coverage ends, the 8-month Special Enrollment Period becomes very important. COBRA generally does not stop that clock. �
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