You can often delay Medicare Part B without a late-enrollment penalty if you or your spouse is actively working and you have qualifying group health coverage based on that current employment. Before delaying, confirm with the employer that the plan qualifies and how it coordinates with Medicare. Part D has a separate rule: keep creditable prescription drug coverage or enroll in a Medicare drug plan within the applicable period. The key is to track when work and coverage end—not just when you turn 65.
Do you need to sign up for Medicare at 65 if you are still working?
Not necessarily. Medicare’s exception to an immediate Part B enrollment is tied to group health coverage based on current employment—your own or, in some cases, your spouse’s. “Employer coverage” alone is not enough to establish that the exception applies. Retiree coverage, COBRA and other arrangements can have different rules.
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Ask the employer’s benefits administrator whether the plan is an employer group health plan based on current employment, whether it is available to everyone at the company, and how it coordinates with Medicare. Medicare’s Working past 65 guidance recommends checking with the employer or benefits administrator when you have other insurance.
Check which coverage pays first
Employer size can affect whether you can rely on workplace coverage without Part B. Medicare warns that coverage from a company with fewer than 20 employees might not pay for services if you do not have both Part A and Part B. Do not assume your work plan pays first just because you receive it through a job. Ask the benefits administrator how claims are paid and whether you need Medicare to avoid unpaid costs.
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Track the Part B Special Enrollment Period
If you qualify based on current-employment coverage, you can generally enroll in Part B while that coverage continues and during the eight months after your employment or the coverage ends, whichever happens first. The clock does not wait for COBRA to expire. Record both the last day of employment and the date the job-based insurance ends, then use the earlier date to plan your enrollment.
For a person who misses the Initial Enrollment Period and has no qualifying exception, delaying Part B can mean waiting for another enrollment period and facing a penalty. The Initial Enrollment Period usually lasts seven months: it starts three months before the month you turn 65 and ends three months after that month. See Medicare’s guidance on when you can sign up.
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COBRA does not extend the Part B deadline
Do not treat COBRA as active-employment coverage for the Part B Special Enrollment Period. If your employment or qualifying job-based coverage ends, the eight-month period can begin even while COBRA continues. Medicare explains this in its guidance on working past 65.
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Retiree insurance generally does not count as coverage based on current work for this purpose. Medicare says retiree coverage may require enrollment in both Part A and Part B and generally pays after Medicare when both apply. Review the plan booklet and ask the administrator what happens to the retiree benefit when you become eligible for Medicare. See Medicare’s information on retiree coverage and other insurance.
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Avoid a separate Part D penalty
Part B and Part D have separate enrollment tests. To generally avoid a Part D late-enrollment penalty, join a Medicare drug plan when first eligible or maintain creditable prescription drug coverage. A gap of at least 63 days without creditable coverage can lead to a penalty. Ask the prescription plan whether its coverage is creditable for Part D, and keep its annual creditable-coverage notices. Details are on Medicare’s late-enrollment penalty page.
What the penalties can cost
If no qualifying exception applies, Medicare describes the Part B penalty as an additional 10% for each full 12-month period you could have had Part B but did not. It is generally added to your monthly premium for as long as you have Part B. For 2026, Medicare lists the standard Part B monthly premium as $202.90; that is a year-specific figure, not a permanent planning amount.
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For Part D, the penalty is generally 1% of the national base beneficiary premium for each month without creditable drug coverage after a gap of at least 63 days. Medicare lists the 2026 national base beneficiary premium as $38.99. Premiums and penalty amounts can change each year, so verify the figure for the relevant plan year. Medicare’s penalty guidance explains these calculations.
Some people who must pay a premium for Part A may also face a penalty: Medicare says the monthly premium may increase by 10%, generally for twice the number of years enrollment was delayed. Most eligible people qualify for premium-free Part A, but anyone who must buy it should check their own eligibility and timing with Medicare.
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How to enroll after job-based coverage
- Confirm the exception. Ask the employer whether the plan is based on current employment, whether it is available to everyone at the company, and how it coordinates with Medicare.
- Check employer size and payer order. Confirm whether the plan may pay only after Medicare and whether you need Part A and Part B for the plan to cover services.
- Verify prescription coverage. Ask whether the drug coverage is creditable for Part D and save the annual notice.
- Write down both end dates. Record when employment ends and when employer health insurance ends; the Part B eight-month window is measured from whichever comes first.
- Start enrollment in time. Contact Social Security or Medicare about enrolling through the applicable Special Enrollment Period. Medicare identifies CMS-L564 for employer verification of current-employment coverage; complete the applicable enrollment request and provide the requested evidence.
- Review COBRA or retiree-plan effects. Check the plan documents and ask the administrator how Medicare enrollment affects your coverage rather than assuming continued coverage preserves your enrollment window.
Where to get plan-specific help
Your benefits administrator can explain how your employer plan coordinates with Medicare and whether its prescription coverage is creditable. For free, individualized Medicare counseling, contact your State Health Insurance Assistance Program (SHIP) through SHIP’s official site. Medicare’s Working past 65 page is also a useful starting point for questions about job coverage, COBRA and enrollment.
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