Medicare Eligibility and Working Past 65

If you plan to keep working after you turn 65, there are some important things about Medicare you should know before you turn 65.

Medicare is a complex program. And it gets more complex if you plan to be one of the growing number of Americans who work past age 65. If you plan to keep working after 65, even if it’s in a job where you’re covered by your employer’s health care, you still need to sign up for Medicare when you turn 65.

Medicare penalty

If you miss the sign-up deadline — which is around your 65^th birthday — you may have to pay one or more penalties, and you may have a gap in coverage later on if you switch from some other insurance to Medicare.

The penalties can be significant, including paying a permanently higher premium for Medicare coverage each month. According to the Congressional Research Service, in 2017 about 701,000 beneficiaries incurred penalties that resulted in total premiums that were 31 percent higher than what they would have been.

Steps to take when you’re about to turn 65: 

1. Start your research. A great starting point is our guide explaining the Medicare basics. 

2. Enroll in Medicare. The Initial Enrollment Period includes the three months before the month in which you turn 65, the month you turn 65, and the three months after you turn 65. Coverage begins one to three months later, depending on when you enroll. 

   • Most people should enroll in Medicare Part A when they turn 65, even if they have employer health insurance, since it’s free for most people (because you or your spouse already paid the Medicare tax through the FICA deduction on your paycheck when you were still working). 

3. Talk to your employer about how Medicare part A works with your employer insurance. 

   • If you or your spouse have insurance through an employer, Medicare Part A may not pay much toward your health care costs because Part A generally pays after your primary insurance. 

   • You can delay Part B or Part D and get them later (for example, when you retire or if you lose your job-related insurance) without incurring a penalty. 

4. Know the Medicare Enrollment Periods. If you work past 65, but didn’t enroll in Medicare during the Initial enrollment Period (when you turned 65), there are two additional Enrollment Periods: 

   • A Special Enrollment Period is available after the employer’s insurance ends (eight months for Part B, two months for Part D); coverage begins the first of the month after you enroll. 

   • If you miss the deadline for your Part B Special Enrollment Period, you have to wait until the General Enrollment Period that runs from Jan. 1 to March 31 each year — and Medicare coverage does not begin until July 1. This gap in coverage presents the risk of large out-of-pocket expenses, medical bills or debt, or inability to access care. 

   • It’s best to enroll in Part B and Part D 90 days prior to the effective end date of your employer coverage. This will help avoid a gap in coverage, and ensure you have your Medicare and insurance cards in hand when your employer coverage ends. 

   • Most people should enroll in Medicare Part A when they turn 65, even if they have employer health insurance, since it’s free for most people (because you or your spouse already paid the Medicare tax through the FICA deduction on your paycheck when you were still working). 

   • If you or your spouse have insurance through an employer, Medicare Part A may not pay much toward your health care costs because Part A generally pays after your primary insurance. 

   • You can delay Part B or Part D and get them later (for example, when you retire or if you lose your job-related insurance) without incurring a penalty. 

   • A Special Enrollment Period is available after the employer’s insurance ends (eight months for Part B, two months for Part D); coverage begins the first of the month after you enroll. 

   • If you miss the deadline for your Part B Special Enrollment Period, you have to wait until the General Enrollment Period that runs from Jan. 1 to March 31 each year — and Medicare coverage does not begin until July 1. This gap in coverage presents the risk of large out-of-pocket expenses, medical bills or debt, or inability to access care. 

   • If you miss your Part D Special Enrollment Period, contact an agent* or visit Medicare.gov to learn more about your enrollment options. 

   • It’s best to enroll in Part B and Part D 90 days prior to the effective end date of your employer coverage. This will help avoid a gap in coverage, and ensure you have your Medicare and insurance cards in hand when your employer coverage ends. 

Don’t be afraid to ask for help

At Mutual of Omaha, we know how confusing it can be to understand Medicare and which options are right for your unique, personal situation. We’re here to listen. 

You can quickly and easily talk to a licensed agent* who is professionally trained to help answer your questions. 

You can also visit the Mutual of Omaha Medicare Advice Center to find answers to common questions as well as recommendations on which Medicare options can work best for you. 

Frequently asked questions 

Q1. Do you have to sign up for Medicare at 65? 

You do not always have to sign up for Medicare exactly at age 65, but timing matters to avoid penalties or coverage gaps. Most people should enroll during their Initial Enrollment Period, which starts 3 months before the month they turn 65 and ends 3 months after. However, if you are still working at 65 and have creditable health coverage through an employer (yours or a spouse’s), you may delay enrolling in Medicare Part B without penalty and sign up later during a Special Enrollment Period. If you don’t have qualifying coverage and delay enrollment, you may face late enrollment penalties and delayed coverage. 

*Oregon and Washington: Agents are referred to as Producers. 

Item #455367_0426