Should You Take Medicare at 65 If You Are Still Working?

The Short Version

If your employer has 20+ employees, you can usually keep employer coverage and delay Part B without penalty. If it has fewer than 20, you should typically enroll in both Part A and B at 65.

The Decision Tree

1. Is your employer's plan creditable coverage for Medicare purposes? Almost always for groups with 20+ employees.
2. Do you contribute to an HSA? You must stop HSA contributions when Medicare starts.
3. Is the employer plan cheaper and better than Medicare + Medigap? Frequently no, once you account for premium contributions.
4. Are you about to retire? Plan a Medicare start date that lines up with employer coverage end.

What to Enroll in Even If You Delay Part B

You can almost always enroll in Part A at 65 - it has no premium for most people. There are exceptions for HSA contributors. We help you think through this in a no-cost consultation.

The Penalty Trap

If you delay Part B without "creditable coverage" credentials, you pay a 10% premium penalty for every 12 months delayed - for the rest of your life. This is the most expensive mistake we see.