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Medicare Basics

Working past 65

Each year, more and more people choose to work past their 65th birthday. If you are planning on working past your 65th birthday, here are a few things you should know to help ensure you get the most out of your health care dollar.

How does Medicare coordinate with my employer coverage?

If you're retired and have Medicare and group health plan (retiree) coverage from a former employer, generally, Medicare pays first for your health care bills and your group health plan coverage pays second.

How your retiree group health plan coverage works depends on the terms of your specific plan. Your employer or union, or your spouse's employer or union, might not offer any health coverage after you retire. If you can get group health plan coverage after you retire, it might have different rules, and might not work the same way with Medicare.

If you are working past 65 and have employer-provided coverage:

  1. Speak with your Benefits Administrator to determine if you need to enroll in Medicare Part A and/or Part B and what coverage options may be available to you as part of your employment. You may have coverage available to you through your employer or through COBRA.
  2. In the months leading up to your 65th birthday, confirm with the employer who provides your health insurance — whether it's your employer or your spouse's — that they will continue to cover you after you turn 65.
    • If their coverage ends when you turn 65, you will need to enroll in Medicare Part A and Part B (also known as Original Medicare). You may also need additional coverage for the costs that Medicare does not cover. Consider a Medicare Advantage or Medicare Supplement (Medigap) plan.
    • If your employer-based coverage continues after you turn 65, then you need to confirm the following three things with your benefits administrator.
      • First, will your group health plan or Medicare be your primary payer?
        If Medicare is primary (which can be the case for businesses with fewer than 20 employees) you may need to enroll in Medicare Part A and Part B.
      • Second, find out if you will you have COBRA or a retiree health plan?
        If the answer is yes to any of these, you may also need to enroll in Medicare Part A and Part B. Be sure to check with your employer about the next steps you should take in these cases.
      • Third, what does your current group plan cover, and how much does it cost?
        Depending on your plan options and health outlook it may be cheaper to drop your group coverage and enroll in a Medicare Advantage plan than keep your employer-based coverage. If you go this route you will also need to enroll in Medicare Part A and Part B so be sure to factor in your Medicare Part B premium.

What if I work for a small company or am self-employed?

If you work for a small company or are self-employed and have an individual or family plan (also known as an individual Qualified Health Plan (QHP)) that you purchased through the Marketplace or private insurance company, it is important to assess the health care options available to you.

  • You can keep your QHP coverage, but it may be a costly choice. If you keep your plan after enrolling in Original Medicare, you may not qualify for any tax credits to help pay for your plan's monthly premium, which will make it much more expensive. There's also no guarantee that your plan will pay anything toward your health or drug claims after Medicare pays, so you may be paying a high premium for little to no coverage.
  • It makes more sense to look into your Medicare choices like Original Medicare with a stand-alone Part D plan and a Medigap policy or a Medicare Advantage plan. These Medicare coverage options may be more comprehensive and have lower costs than keeping your QHP.

Can I delay Part A and Part B?

If you don't sign up for Medicare Parts A, B, or D when you are first eligible — either during your initial enrollment period or special enrollment period, if it applies — Medicare may add late enrollment fees to your monthly premiums.

What if I have a health savings account (HSA)?

If you have an HSA, you can withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses (like deductibles, premiums, coinsurance or copayments).

Health Savings Accounts (HSA) and Medicare

If you have an HSA, you can withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses (like deductibles, premiums, coinsurance or copayments).

You can't contribute to your HSA once your Medicare coverage begins. If you contribute to your HSA after your Medicare coverage starts, you may have to pay a tax penalty. If you'd like to continue contributing to your HSA, you shouldn't apply for Medicare, Social Security, or Railroad Retirement Board (RRB) benefits.

Learn more at Signing up for Medicare: Special conditions

Website Last Updated: 10/1/2016
Y0041_HM_17_43499 Approved 10/7/2016