Free Guide · 2026 · Updated August 2026

Do I Need Medicare at 65 if I'm Still Working?

It depends on your employer's size and your coverage. Get this wrong and you can owe a permanent penalty — here is how to get it right.

If your employer has 20+ employees

You can usually delay Part B without penalty and stay on your employer's group plan. When that coverage ends, you get an 8-month Special Enrollment Period to sign up for Part B penalty-free. Many people still take premium-free Part A at 65.

If your employer has fewer than 20 employees

Medicare usually becomes your primary coverage, so you generally should enroll at 65 during your Initial Enrollment Period — delaying can leave gaps and trigger penalties. Confirm with your benefits administrator.

The penalty risk

If you delay without qualifying employer coverage, the Part B late penalty is 10% per full year — permanently. Always verify whether your coverage counts as creditable before delaying.

Health Savings Accounts (HSAs)

One catch: you cannot contribute to an HSA once you're enrolled in any part of Medicare, including premium-free Part A. If you want to keep contributing, you may need to delay all of Medicare — plan the timing carefully.

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Frequently asked questions

Can I delay Medicare if I'm still working at 65?

Often yes, if your employer has 20+ employees and you have creditable group coverage. You get an 8-month Special Enrollment Period to enroll in Part B penalty-free when that coverage ends.

Will I owe a penalty if I delay Medicare while working?

Not if you have qualifying employer coverage from an employer with 20+ employees. Without creditable coverage, the Part B penalty is 10% per year, permanently.

Can I keep my HSA on Medicare?

No. You cannot contribute to an HSA once enrolled in any part of Medicare, including premium-free Part A.

Official sources

Figures on this page are verified against U.S. government primary sources: