I’m 64 and Still Working in Raleigh — When Exactly Do I Need to Enroll in Medicare to Avoid Penalties?
The answer hinges on one number: how many people your employer has on payroll. A 10-minute call gets you the exact answer — free, no obligation.
I answer my own phone in March. A call center hands you a different agent every year — I’m the same broker who set up your plan, and I’m who you call when a claim gets denied.
What happens if I get Medicare enrollment wrong while still working?
These are the four questions I hear most from Raleigh-area workers approaching 65.
The 10% surcharge for each 12-month period you delayed is added to your Part B premium for life. There is no cap, no forgiveness, and no appeals process. A 3-year delay = 30% higher Part B premium forever. In 2026, that’s an extra $60.87/month on top of $202.90 — for life. One phone call to verify your employer size prevents this entirely.
What does a broker check that Medicare.gov doesn’t?
| What do you need to know? | Medicare.gov | Rob Simm — NC #10447418 |
|---|---|---|
| Employer size verification | Tells you the 20-employee rule exists | I call your HR and verify the exact count before you make a decision |
| Penalty calculation | Shows the formula — 10% per 12 months | I run the math with your specific delay period and show you the lifetime cost |
| SEP timeline | Says you get 8 months after employment ends | I map your exact start date, end date, and enrollment deadline on a calendar |
| COBRA trap | Buries the COBRA exclusion in fine print | I flag it immediately — COBRA does not protect you from the penalty |
| CMS-L564 form | Doesn’t mention it unless you search | I tell you to get it from HR before your last day — it’s your proof of coverage |
| Ongoing support | Different agent every call, hold times | Same broker, same phone number, same answer next year |
What are the key Medicare costs for Wake County residents in 2027?
If you work for a Raleigh-area employer with between 15 and 25 employees, do not rely on HR’s word alone — the 20-employee threshold is based on the number of employees the company had for 20 or more calendar weeks in the current or preceding year. Seasonal fluctuations can push a company above or below the threshold year to year. I verify this directly so you don’t find out the hard way at enrollment.
Now pick how you want to move forward — your pace.
Prefer to just talk? (828) 761-3326
What does a Part B penalty actually cost over a lifetime?
How much does it cost to talk to a Medicare broker?
It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.
Which WakeMed facilities serve Wake County?
WakeMed is the health system on record for Wake County, and 3 facilities in the county carry its name — which does not mean they all sit on the same plan contracts.
- WakeMed Raleigh Campus
- WakeMed Cary Hospital
- WakeMed North Hospital
WAKEMED NETWORK NOTES
WakeMed went out-of-network with all UnitedHealthcare plans on 15 November 2025, commercial and Medicare Advantage alike, after the two sides could not agree on rates. WakeMed hospitals, outpatient clinics, 210 PET, urgent cares and physician specialists are all out of network. Verified .
The carve-out is the part people get wrong. WakeMed's primary care physicians and MyCare365 sit on a separate contract and did not go out-of-network — but physician specialists did. So a Wake County patient on a UnitedHealthcare Medicare Advantage plan can keep seeing their WakeMed primary care doctor in-network while every WakeMed hospital admission, ER visit, imaging appointment and specialist visit bills at out-of-network rates. Keeping your doctor is not the same as keeping your hospital, and the hospital is where the money is. Verified .
This is not isolated to Raleigh. UnitedHealthcare is reducing its Medicare Advantage footprint across 109 counties in 16 states for 2026. A UnitedHealthcare plan that worked in Wake County in 2025 is worth re-checking for 2026 whether or not you have heard from the carrier. Verified .
Can I delay Medicare if I’m still working past 65 in Wake County?
What is the Part B late enrollment penalty in 2026?
How do I prove I had creditable employer coverage?
What is the Medicare Special Enrollment Period for people who work past 65?
Are there Medicare brokers in Wake County, NC?
Now pick how you want to move forward — your pace.
Prefer to just talk? (828) 761-3326