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I'm Turning 65 but I'm Still Working - What Do I Need To Do?

Turning 65 doesn’t always mean you must enroll in Medicare right away. If you or your spouse are still actively working and covered under a current employer group health plan, your options may be different.

Below is a simple guide to help you decide what to do.

Do I Need to Enroll in Medicare Part A?

Most people enroll in Part A at 65 because it’s usually premium-free.
However, do NOT enroll in Part A if:

You are contributing to an HSA (Health Savings Account)

Your employer advises against it due to reimbursement rules.

Part A

Part B

Do I Need to Enroll in Medicare Part B?

You can delay Part B with no penalty if BOTH are true:

You’re covered under your or your spouse’s ACTIVE employer plan

The company has 20+ employees

If the employer has fewer than 20 employees, Medicare becomes primary—you should take Part A and Part B at 65.

What If My Spouse Is Still Working

and I’m on Their Plan?

You are allowed to delay Part B if:

Your spouse is actively working

You are covered on their current employer plan

How to Enroll in Part B Later (Past 65)

When you retire or lose employer coverage, you have an 8-month Special Enrollment Period (SEP)

to enroll in Part B without penalty. You will need:

1. CMS L564 Form Completed by your employer confirming you had creditable coverage.
(Download L564)

2. Part B Application (CMS-40B)

Submitted to Social Security.

What If my Spouse is still Working?

IRMAA at Retirement

How to Avoid Overpaying for IRMAA at Retirement

When you retire, your income usually drops.
You can request SSA to lower or remove your IRMAA using:

SSA-44 – Life Changing Event Form

Select “Work Stoppage” or “Work Reduction” after retirement.

How Employer Insurance Works With Medicare

Medicare has specific rules on who pays first:

Employer Plan (20+ employees) → Employer pays first

Employer Plan (<20 employees) → Medicare pays first

COBRA or Retiree Coverage → Medicare pays first (you cannot delay Part B)

Employer Insurance

Need Help?Topflight Medicare can guide you through: ✅ Whether you should delay Part B ✅ When to apply ✅ What forms you need ✅ How your employer plan coordinates with Medicare

Not affiliated with the United States government or federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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