Medicare Guide
Working Past 65: Medicare vs. Employer Group Coverage
Still on your employer's health plan? Here's exactly what you need to know before you turn 65.
If you or your spouse are still working at 65 and covered by an employer group health plan, you have options — and important decisions to make. Getting this wrong can cost you thousands in penalties and coverage gaps.
Employer Plan vs. Medicare + Medigap
| Factor | Employer Group Plan | Medicare + Medigap |
|---|---|---|
| Monthly Premium | Often subsidized by employer | Part B (~$185) + Medigap (~$100–$200) |
| Doctor Choice | Limited to network | Any doctor who accepts Medicare — nationwide |
| Out-of-Pocket Max | Varies widely by plan | Predictable with Medigap Plan G or N |
| Drug Coverage | Usually included | Requires separate Part D plan |
| Retirement Flexibility | Coverage ends when you leave | Portable — follows you anywhere |
| Specialist Access | May require referrals | No referrals needed with Original Medicare |
Key Rules for Working Past 65
Part A is usually free — enroll anyway
Most people qualify for premium-free Part A. Enrolling at 65 costs nothing and gives you a hospital coverage backstop even while on employer insurance.
You can delay Part B without penalty — if covered by employer insurance
If your employer has 20+ employees and you are actively employed (not COBRA), you can delay Part B enrollment without penalty. You get a Special Enrollment Period when you retire.
COBRA does NOT count as creditable coverage for Part B delay
If you retire and go on COBRA, you must enroll in Part B within 8 months of losing active employer coverage — or face the permanent penalty.
Check whether your employer plan is 'creditable' for Part D
Your employer must notify you annually whether your drug coverage is creditable. If it is not, you should enroll in Part D to avoid future penalties.
Medigap guaranteed issue rights apply at retirement
When you retire and enroll in Part B, you have a 6-month guaranteed issue window to buy any Medigap plan without medical underwriting.
Your Special Enrollment Period (SEP) at Retirement
When you stop working or lose employer coverage, you get an 8-month Special Enrollment Period to sign up for Part B without penalty. Do not wait for the Annual Enrollment Period — the SEP is separate and more favorable.
Missing your SEP means waiting until the General Enrollment Period (January–March) with coverage starting July 1 — and paying the late penalty permanently.
Not Sure Which Path Is Right for You?
We'll compare your employer plan against Medicare options side by side — free of charge.