Turning 65? If you are still working and have good health insurance through your job, you might be wondering if you really need to sign up for Medicare right now.
The short answer is: You can wait to sign up for Medicare, as long as you meet certain criteria
Why Should I Wait?
Medicare is split into parts.
- Part A (Hospitals): This is usually $0 if you’ve worked in the U.S. for at least 10 years. Most people sign up for this at 65.
- Part B (Medical): This costs money. In 2026, the standard monthly bill is $202.90 + IRMAA
Medicare vs Group Plan
Even though Medicare is great, your employer group plan might actually be the better deal right now for three big reasons:
- Covering a Younger Spouse: Medicare is strictly individual insurance. If you turn 65 but your spouse is younger or you have children on the employer group plan, moving to Medicare means they lose their coverage… but this could be solved – see our COBRA blog
- It Can Be Cheaper Overall: Your employer likely pays a big chunk of your monthly insurance costs – making your work plan a less expensive plan for comprehensive coverage
- Company HSA Contributions: If your work plan is a High Deductible Health Plan, your employer might put “their own contribution” into your Health Savings Account (HSA) every year. The moment you sign up for any part of Medicare Part A, you lose the ability to get or make any HSA contributions.
- IRMAA – if you are working past 65, your high MAGI will trigger IRMAA (income surcharges) which can take medicare from being competitive and affordable to an expensive idea. Always consult!
The “20 Employee” Rule: Can I Safely Wait?
Before you decide to wait, you must know how many people work at your company.
- 20 or more employees: You are safe! You can keep your work insurance and delay Medicare A and or Medicare Part B without any gaps and penalties.
- Fewer than 20 employees: You must sign up for Medicare Part A and Part B at 65. If you don’t, your work insurance might stop paying your medical bills.
(Note: If your insurance comes from your spouse’s job, these exact same rules apply to their company.)
The HSA Rule
Do you put money into a Health Savings Account (HSA) at work? Listen closely: You cannot put money into an HSA if you have any part of Medicare.
If you plan to sign up for Part A at 65 but delay Part B, you must stop putting money into your HSA. Refer to our other blog about HSA contributions. Remember, collecting SS automatically enrolls you in Part A.
Ready to Retire or keep your group plan?
Ready to Retire and enjoy the Medicare world?
Check out our Retirement Blog as you will need proof once you are older than 65
