Working Past 65
So, You’re 65 and Still Working... Now What?
While many dream of retiring early, the reality is that most of us continue working well past 65. Whether it’s for financial stability or the benefits, some people even return to work after retiring just to keep those benefits.
I’m Kristen, a licensed insurance professional with 15 years of experience, and I’m here to help you navigate the insurance landscape after 65, especially when it comes to Medicare.
Let’s Start with the Basics: What Is Medicare?
At 65, you become eligible for Medicare, a federal health insurance program for those 65 and older, or for individuals under 65 who have been disabled for at least 2 years.
Medicare has two main parts -- Part A and Part B
We’ll save the deep dive into all the details for another time, but today, we’re focusing on how working past 65 affects your Medicare eligibility.
Do You Have to Enroll in Medicare If You’re Still Working?
Here’s where it can get tricky. There are rules in place that determine this for you. Whether or not you are required to enroll in Medicare depends on:
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If your employer has fewer than 20 employees, yes, you must enroll in BOTH PARTS of Medicare because it becomes your primary insurance and your employer plan is secondary
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If your employer has more than 20 employees, you have options. Medicare may not be mandatory, and you may be able to delay enrollment without facing penalties.
- If you are self employed, you most likely have to enroll in Medicare because your plan is probably not considered creditable group coverage
- If you receive coverage from a State exchange or marketplace, yes, you must enroll in BOTH PARTS of Medicare
If you’re unsure where you stand, always ask your HR department or Insurance carrier. The key question to ask is:
“Does my health plan require Medicare enrollment at age 65”
What happens if I don't enroll?
If your plan requires you to enroll, it means that Medicare should be your primary insurance and your employer plan would be secondary. Insurance companies do not like to pay for services when they don't have to and if you were supposed to be covered by one and not the other - you could face a battle of the claims. Trust me, you don't want to end up there. Further, there are potential penalties for not enrolling in Medicare when required:
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For each 12 months you go without enrolling in Medicare when required, your Part B premium will increase by 10% -- And guess what? You pay that penalty, monthly, for life. It never goes away
- Your employer plan could deny any and all claims you had for medical services past your required enrollment date (THIS could be a significant problem)
Choosing Between Medicare and Your Employer Plan
Once you’ve figured out whether your current coverage is creditable, the next step is determining whether staying on your group plan or exploring the Medicare market is the better option for you. And here’s a crucial point: cost should not be the sole deciding factor. There are hundreds of Medicare plans with varying levels of coverage and cost, so you’ll want to consider your healthcare needs and budget—not just price.
Now, many people assume that employer-sponsored coverage is always better. That’s not necessarily true. In my experience, a great majority of group plans have high out-of-pocket maximums or large deductibles, which you could completely avoid with Medicare. If you’re taking expensive medications, you might find that Medicare’s out-of-pocket caps can significantly reduce your costs, making it a better choice financially. Of course, there are exceptions—your group plan may be one of those rare, unicorn scenarios where you’re fortunate enough to have excellent coverage at an amazing price. In the latter scenario, you very well could be better off remaining where you are. Truthfully, most people don’t know what options are out there or how to compare them...insurance is complex, and without a professional guiding you through the options, you could easily miss important details.
To spare you from further overwhelm, let’s focus on the most important takeaways
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You don’t have to keep working just for the benefits. If you’re ready to retire, there are plenty of great Medicare plans and options available in the market.
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If you’re still working, don’t assume you can avoid Medicare until you fully retire. Simple mistakes can be costly down the road.
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Use a professional. There’s a reason you don’t ask your gardener to do your taxes. We all have our areas of expertise, and if Medicare isn’t yours, it’s worth finding someone you can trust to guide you.
My consultations are no-cost—whether it’s a simple chat or a complex enrollment process, it won’t cost you a thing. So, call, click, or text, and let’s figure out what’s best for you!