Working Past 65 and Medicare Eligibility

Understand your Medicare and employer group health plan options

You are eligible for Medicare even if you are still working and receiving Social Security benefits or other income. If you have group health plan coverage from an employer, you may be able to delay Medicare enrollment — especially if your plan qualifies as creditable coverage.

Should I keep my employer coverage or enroll in Medicare Part A and Part B?

If you continue working after turning age 65, you’ll need to decide whether to:

• Stay on your employer group health plan
• Enroll in Medicare Part A hospital insurance and/or Part B medical insurance
• Use both together

Start by asking your employer if your coverage is creditable — meaning it meets or exceeds Medicare standards. This matters for drug coverage, too. Your employer is required to send a Notice of Creditable Coverage each year. Keep this document in case you delay Medicare enrollment.

If your plan is not creditable, you’ll need to enroll in Medicare during your Initial Enrollment Period (IEP) to avoid penalties.

How to compare your Medicare benefit and employer coverage

When you turn 65 or approach retirement, compare the benefits of your employer group health plan with Medicare. Consider:

• Monthly premiums and out-of-pocket costs
• Access to doctors and hospitals
• Prescription drug coverage
• Whether Part A and Part B provide better value than your current plan

You may choose to stay on your employer plan and enroll in Part A only, since it’s usually premium-free. In this case, Medicare may serve as secondary insurance, with your employer plan remaining primary.

Talk to your benefits administrator before you enroll in Medicare

Your company’s benefits administrator can explain how your current plan works with Medicare coverage. This includes:

• Whether your plan is creditable
• How claims will be paid if you have both Medicare and employer insurance
• How Medicare may impact your Health Savings Account (HSA) eligibility

Going back to work? You may qualify for a Special Enrollment Period (SEP)

If you return to work and get employer group health plan coverage that’s creditable, you can drop Medicare and re-enroll in your job-based plan. Later, when you stop working again, you’ll be eligible for a Special Enrollment Period (SEP) — a time when you can enroll in Part B medical insurance without late penalties.

Medicare and Marketplace coverage if you're self-employed

If you are self-employed and covered through the Health Insurance Marketplace, you must enroll in Medicare once you become eligible. Staying on your Marketplace plan could affect your tax credits and savings, so it’s a good idea to consult your accountant.

You may keep your Marketplace plan as secondary coverage, but you’ll still need to enroll in Medicare to avoid gaps or penalties.

Planning your Medicare enrollment when you retire

If you delayed Medicare enrollment while covered by an employer group health plan, plan ahead for when you retire:

• Gather your Notice of Creditable Coverage
• Understand your Initial Enrollment Period or SEP
• Compare Part A hospital insurance, Part B medical insurance and drug coverage options

Have questions? Learn more from Banner Medicare Advantage

• Learn more about Banner Medicare Advantage plans

Contact Banner Medicare Advantage to speak with a licensed sales agent:

Call 833-516-1007, TTY 711

Hours of operation:

• October 1 – March 31: 8 a.m. to 8 p.m., seven days a week
• April 1 – September 30: 8 a.m. to 8 p.m., Monday through Friday