Do you need Medicare if you still work at 65? It depends on your employer coverage (and sometimes company size). Hereās how to avoid late penalties, keep your doctors, and time your enrollment correctly.
ā Do You Need Medicare If You Still Work?
If youāre asking ādo you need Medicare if you still workā, youāre not alone. This is one of the most confusing Medicare questionsābecause the ārightā answer depends on what kind of coverage you have right now and who itās through.
Hereās the big idea in plain English:
If your health insurance is from a current job (yours or your spouseās), you may be able to delay some parts of Medicare without penalties. Medicare
If your coverage is not from a current job (like COBRA, retiree coverage, Marketplace, VA, etc.), the rules can change and you can accidentally trigger penalties. Medicare
If you want a quick āstart here,ā use these helpful pages (bookmark them): GenerationHealth.me and Medicare.gov. Medicare
Also, if you want help comparing choices, you can start here: GenerationHealth.me/Medicare-quote.
Can You Delay Medicare While Still Working?
Yes ā in many cases you can. If youāre still working past 65 and have creditable health insurance through your employer (or your spouseās), you can delay enrolling in Medicare Part B without paying a penalty later.
Creditable coverage means your employer plan is as good as or better than Medicareās standard coverage. Most large employers (20+ employees) qualify. However, if your employer has fewer than 20 workers, you usually need to enroll in Medicare when first eligible because Medicare becomes your primary insurance.
š³ How do you pay Medicare premiums if you are still working?
If you enroll in Part B while working, premiums are typically paid monthly through Social Security billing or automatic bank draft. Some employers reimburse Part B costs. Medicare.gov outlines payment options and coordination rules with employer-sponsored health plans.
š° Does Medicare cost more if you are still working?
Medicare doesnāt cost more simply because youāre employed. However, enrolling late without qualifying coverage can trigger penalties. Medicare.gov clarifies how employer size and coverage type affect costs, penalties, and when Part B enrollment is required.
Most people start here to compare options privately ā no contact info, no obligation, and no enrollment required.
š Penalty Percentages (what late enrollment REALLY costs)
Letās keep this simple and specific.
Part B late enrollment penalty (medical coverage)
If you donāt enroll in Part B when youāre supposed to (and you donāt qualify for a Special Enrollment Period), Medicare can add a 10% penalty for each full 12-month period you delayed. That penalty is added to your Part B premium. Medicare CMS
Example: If you delayed 2 full years, thatās a 20% penalty. Medicare
Part D late enrollment penalty (drug coverage)
If you go without ācreditableā drug coverage and delay Part D, the penalty is typically 1% per month (based on the national base beneficiary premium) times the number of uncovered months. Medicare adds it to your Part D premium. Medicare
Bottom line: penalties can follow you for a long timeāso itās worth getting the timing right.
If you want step-by-step enrollment help, use: How to sign up for Medicare Parts A and B.
Ā
š§¾ Comparison tables (quick answers by situation)
Table 1: āShould I enroll now, or can I wait?ā
| Your situation at 65 | Usually safe to delay Part B? | Why |
|---|---|---|
| You (or spouse) have active employer group coverage | Often yes | You may qualify for a Special Enrollment Period when work/coverage ends Medicare |
| You have COBRA or retiree coverage | Often no | COBRA/retiree coverage usually doesnāt count as active employer coverage for delaying Part B Medicare |
| You have Marketplace (ACA/Obamacare) coverage | It depends | Medicare rules can differ; delaying Medicare can create gaps Medicare |
Table 2: Parts A, B, and D in plain English
Need help comparing Medicare Advantage options later? Use: How to compare Medicare Advantage plans in North Carolina.
Ā
This is where most people begin when they want to compare options quietly ā no contact info, no obligation, and no enrollment required.
š Hereās what we see
As a broker, here are the most common real-world situations we see with do you need Medicare if you still work:
People assume āIām still working, so Iām automatically fine.ā
But if coverage is COBRA, retiree, or not tied to active work, that assumption can backfire. MedicarePeople donāt realize they need a proof form when leaving employer coverage.
Medicare notes you may need extra forms showing you had job-based coverage while working to use the Special Enrollment Period. MedicarePeople miss the 8-month window and get hit with Part B penalties.
Your Part B Special Enrollment Period is commonly described as 8 months after you stop working (or lose job-based coverage). Medicare
If youāre in North Carolina and want local help, start here: Medicare agent near me in North Carolina.
š§ Explicit explanations (no jargon)
Letās answer this the way youād explain it to a family member:
What does āstill workingā mean (for Medicare rules)?
It means you (or your spouse) have health coverage from a current jobānot a past job. Medicare
Whatās a āSpecial Enrollment Periodā (SEP)?
Itās a special window where you can enroll in Part B after 65 without a penalty because you had job-based coverage while you (or your spouse) were working. Medicare
Do I have to take Medicare at 65?
Not always. Medicare.gov specifically notes that if you or your spouse are still working, Medicare āworks a little differently,ā and you may be able to wait to sign up for Part B without penalty (depending on your situation). Medicare
And yesādo you need Medicare if you still work can honestly be āyesā for one person and ānoā for another.
šļø ( Enrollment timelines (the dates that matter)
Here are the timelines you should know:
1) Initial Enrollment Period (IEP) around age 65
Your initial Medicare enrollment window happens around the month you turn 65. (Social Security summarizes this timing and how it relates to other enrollment options.) Social Security
2) Special Enrollment Period (SEP) when you leave employer coverage
Medicare explains that your 8-month SEP for Part B starts when you stop working (even if you choose COBRA afterward). Medicare
Simple rule: If youāre going to delay Part B because youāre working, set a reminder for the month your work coverage endsāand start the Part B enrollment process right away.
You can also see SSAās Part B enrollment info here: ssa.gov. Social Security
What Happens If You Delay Enrollment Without Creditable Coverage?
If you skip Medicare Part B and your coverage isnāt creditable, you may face a lifetime late-enrollment penalty that increases your monthly premium by 10% for every 12 months you delayed.
Additionally, you might experience a coverage gap because you can only enroll later during the General Enrollment Period (January 1 ā March 31), with coverage starting July 1.
Always confirm your employer planās status with HR before declining Medicare coverage.
Do you need to sign up for Medicare drug coverage (Part D) if youāre still working at 65?
If your employer planās drug coverage is not ācreditableā (not as good as Medicareās standard), delaying Part D can trigger a permanent late-enrollment penalty. This penalty is 1% of the national base Part D premium for every full month you went without creditable drug coverage after your Initial Enrollment Periodāand itās added to your Part D premium for as long as you have Medicare drug coverage.
Best Strategy for Working Adults Near Retirement
Check with HR: Ask if your company plan is creditable.
Compare costs: Sometimes Medicare Part B + a supplemental plan costs less than your employer plan.
Review prescription coverage: Ensure your drug plan is creditable to avoid Part D penalties later.
Plan your transition: Once you retire, youāll have an 8-month Special Enrollment Period to join Medicare without penalties.
Consult a licensed agent: GenerationHealth can help you evaluate whether staying on your current plan or switching to Medicare makes better sense financially.
If youāre just looking to double-check your options, most people start here ā you can compare privately with no contact info, no obligation, and no enrollment required.
FAQā
1) Do you need Medicare if you still work and you already have āgreat insuranceā?
Maybe. If itās active employer coverage, you may be allowed to delay Part B without penalty. But you still want to check rules so you donāt accidentally trigger penalties or gaps. Medicare
2) Should I enroll in Part A at 65 if Iām still working?
Many people enroll in premium-free Part A, but there are exceptions (example: HSA contribution issues). For your exact case, confirm before enrolling.
3) If I delay Part D, how do I avoid the penalty?
You generally need ācreditableā prescription drug coverage. Otherwise, Medicare can apply a 1% per month penalty. Medicare
4) What if my spouse is still working and Iām covered under their plan?
Medicare.gov notes that coverage from your spouseās job can also be part of the working-past-65 scenario. Medicare
5) Whatās the fastest way to compare Medicare options when Iām ready?
Start here: Free Medicare quotes online and GenerationHealth.me/Medicare-quote.
š§© In our experience
When people get this right, itās usually because they do three things:
They ask HR: āIs my coverage considered active employer group coverage for Medicare rules?ā
They learn their exact end date for coverage (not the last day workedācoverage can end later).
They start Part B paperwork early so they donāt miss the SEP window. Medicare
If youāre turning 65 soon, this page helps too: Turning 65 Medicare enrollment in NC.
š« What most sites get wrong
A lot of articles oversimplify and say: āIf youāre working, you can wait.ā Thatās not always true.
Common mistakes online:
Treating COBRA like active employer coverage (it usually isnāt for delaying Part B) Medicare
Ignoring drug coverage rules (Part D penalties can add up monthly) Medicare
Not mentioning the 8-month Part B SEP clock Medicare
This is why the question do you need Medicare if you still work should be answered with your exact coverage type in mind.
ā Common outcomes (what usually happens)
Here are the most typical āendingsā we see:
Outcome A (best case): You keep employer coverage, delay Part B correctly, then enroll during the SEP with no penalties. Medicare+1
Outcome B: You enroll in Part A at 65, keep working, and later add Part B at retirement (timed correctly). Medicare
Outcome C (painful): You assume COBRA counts, you delay Part B, the SEP clock runs out, and you get hit with a long-term penalty. Medicare
šÆ Who this is for
This guide is for you if:
Youāre turning 65 and still working (or covered under a working spouse). Medicare
You want to avoid penalties and do it once, the right way. Medicare
Youāre comparing ākeep employer plan vs Medicare vs Medicare Advantage.ā
You want a plain-English answer to do you need Medicare if you still work without sales pressure.
If youāre in North Carolina and want help locally, start here: Medicare agent near me in North Carolina.
Ā
š Conclusion
Soādo you need Medicare if you still work? Sometimes yes, sometimes no.
If your coverage is tied to a current job, you may be able to delay Part B without penalty, as Medicare explains for working past 65. Medicare
But if your coverage is COBRA, retiree, Marketplace, or something else, you need to be carefulābecause late enrollment penalties (like 10% per 12 months for Part B and 1% per month for Part D) can follow you. Medicare
If you want a simple next step: get your options side-by-side here: GenerationHealth.me/Medicare-quote and Free Medicare quotes online.
š§āš¼ About the Author
Rob Simm is a licensed U.S. health insurance advisor and founder of GenerationHealth.me, specializing in Medicare, ACA Marketplace coverage, and supplemental health plans. With years of hands-on experience helping individuals, families, and seniors navigate complex insurance choices, Rob focuses on simplifying coverage options, breaking down costs, and guiding clients toward plans that truly fit their needs.
He is certified annually with top national carriers, trained in CMS compliance standards, and actively supports clients across North Carolina, Virginia, and multiple U.S. regions. Rob is known for his clear explanations, data-driven approach, and commitment to ethical, transparent insurance guidance.
When heās not helping people compare plans or lower healthcare costs, Rob continues researching federal updates, Medicare rule changes, and marketplace trends to ensure every article at GenerationHealth.me reflects the most accurate, current information available.
For personalized help with Medicare or Marketplace coverage, connect with Rob at GenerationHealth.me.
š Based in North Carolina | āļø (828)761-3324 | āļø Contact Rob
āļø Compliance & Trust Disclaimer
Information provided on this page is for educational purposes only and should not be considered legal or financial advice.
Plan availability, premiums, and benefits may vary by location and carrier.
Always verify specific details with a licensed insurance professional or directly with Medicare.gov before enrolling.
GenerationHealth.me and Robert Simm are independent agents and not affiliated with or endorsed by the U.S. government or the federal Medicare program.