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Medicare Coverage for Individuals Working Past 65

All, Medicare

The current U.S. workforce is composed of 10.6 million people who are 65+ years old, according to the Bureau of Labor Statistics1 – and many of those professionals are not leaving the workforce anytime soon.

The choice to continue working after 65 is one that is facilitated by many societal factors, including inflation, financial woes spawned by the pandemic, and even longer lifespans. If you are at (or approaching) 65 and not retiring, it’s important to understand how Medicare and your current employer insurance coverage interact.

Avoid gaps in coverage by working with M3 Elevate’s Medicare experts. They can assist you with your questions, and find the best plan and value based on your individual needs.

Enrolling in Medicare

Let’s first discuss instances when individuals must enroll in Medicare.

Do I need to sign up for Medicare when I turn 65 and I’m still working? Yes if…

  • You are self-employed or the company does not offer insurance to all employees
  • Your employer has less than 20 employees
  • You are on COBRA

Once you are enrolled, the Centers of Medicare & Medicaid Services (CMS) will send you a Welcome to Medicare packet and Medicare card in the mail. You will also receive the Medicare & You Handbook which contains information regarding your Medicare coverage choices. Read through our additional articles on Medicare.

How Employer Coverage works with Medicare Part A and B

*According to Medicare.gov2

I’m still working and my (or my spouse’s) workplace has less than 20 employees.

How my coverage works with Medicare (Part A and B):

  • Medicare pays first, and job-based insurance pays second for services
  • Your job-based insurance may not cover the costs of services if you don’t sign up for Part A and Part B
  • Reminder: ask your employer who provides your health insurance if you should sign up for Part A and B when you turn 65

I’m still working and my (or my spouse’s) workplace has more than 20 employees.

How my coverage works with Medicare (Part A and B):

  • Job-based insurance pays first, and Medicare pays second for services
  • If you don’t have to pay a premium for Part A, you can sign up when you turn 65 or older
  • Reminder: you won’t have to pay a late enrollment fee if you wait to stop working, or lose your health insurance (whichever comes first) before you sign up for Part B

I’m still working and I (or my spouse) get a stipend from my employer to purchase my own health insurance OR I am still working, but don’t have health insurance through the employer.

How my coverage works with Medicare (Part A and B):

  • In general, Medicare doesn’t work with insurance you purchase on your own
  • Medicare pays first when you sign up
  • Reminder: Ask your health insurance company if you need to sign up for Part A and B when you turn 65

Medicare Part D Coverage

It’s recommended that individuals 65+ have some form of drug coverage through Medicare Part D or employer coverage due to the high out-of-pocket drug costs.

Below is a breakdown of different scenarios based on current drug coverages, from Medicare.gov2.

If you…Follow this…
Don’t have any drug coverageEnroll in a Medicare drug plan or Medicare Advantage Plan with drug coverage within three months from when your coverage starts – thus avoiding a monthly Part D late enrollment charge.
Have drug coverage that’s “credible”Wait to get Medicare drug coverage.
Have drug coverage that’s “not credible”Enroll in Medicare Part D (Medicare Advantage Plan) within the first three months from when your Medicare coverage begins – thus avoiding a monthly Part D late enrollment charge.

Key Takeaways

When you continue working over the age of 65, it can be confusing to understand which parts of Medicare you should enroll in and how they interact with your employer or private coverage. M3 Elevate is here to alleviate the stress of determining the best solution when it comes to your healthcare coverage.

Our experts have been navigating the complex rules of Medicare and provide an individualized approach for over a decade. Whether you or your employees are nearing retirement, turning 65, or looking for general information about Medicare, turn to M3 Elevate for guidance.

Twice a month, M3 Elevate leads on Medicare Education Sessions. These events are complimentary and intended for educational purposes. Register for any one of these events, from now through September, and get your Medicare questions answered.

Register for the bi-monthly complimentary Medicare education sessions
*Sessions led by Jason Haglund and Virginia Van Haren

If you would like further information on Medicare coverages, reach out to Jason Haglund.


Sources:

Bureau of Labor Statistics1

Medicare.gov2

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