Medicare 2026

Still Working at 65 in Benton? Here's How Medicare Fits In

Turning 65 while you're still on the job can feel like a puzzle. In Benton, plenty of workers are staying employed past traditional retirement age — and many are wondering whether they need to sign up for Medicare right away, keep their employer plan, or somehow do both. The answer depends on a few key details about your workplace and your coverage.

Key takeaways

• If your employer has 20 or more employees, your job-based plan usually pays first and you can often delay Part B without a penalty.
• If your employer has fewer than 20 employees, Medicare usually pays first — and delaying Part B could leave gaps in your coverage.
• Once your employer coverage ends, you get an 8-month Special Enrollment Period to sign up for Part B without a late penalty.
• COBRA and retiree coverage do NOT count as active employer coverage for delaying Medicare, so watch those deadlines closely.

Start with your Initial Enrollment Period

Your Initial Enrollment Period is a 7-month window: the 3 months before the month you turn 65, your birthday month, and the 3 months after. Most people are automatically enrolled in Part A (hospital) if they're already drawing Social Security. Part A has no premium for most workers who paid Medicare taxes for at least 10 years, so many people sign up for it even while working.

Part B (doctor visits and outpatient care) is different. It has a monthly premium, and whether you should take it right at 65 depends on your employer's size.

The 20-employee rule

This is the single most important detail for working Benton residents approaching 65.

If your employer has 20 or more employees, your group health plan is the "primary payer." You can usually delay Part B while you keep working, and you won't owe a late enrollment penalty when you sign up later.

If your employer has fewer than 20 employees, Medicare typically becomes the primary payer at 65. That means your employer plan may pay very little — or nothing — for services Medicare would have covered. In that case, most people need to enroll in Part B on time to avoid coverage gaps.

Ask your HR department, in writing, whether your plan is primary or secondary to Medicare. Don't guess.

What happens when you leave the job

When your employment or your employer coverage ends, you get a Special Enrollment Period of up to 8 months to sign up for Part B without a late penalty. You also get a 2-month window to join a Medicare Advantage or Part D plan.

One important warning: COBRA and retiree health coverage do not count as active employer coverage for Medicare purposes. If you're relying on COBRA past 65 and skip Part B, you could face a lifelong late enrollment penalty and a wait for coverage to begin. Sign up for Part B before or shortly after your active job ends.

Don't forget prescription drugs

If your employer plan includes prescription drug coverage that Medicare considers "creditable," you can delay Part D without a penalty. Your plan is required to send you a notice each year telling you whether your drug coverage is creditable — hang onto it.

For 2026, Medicare's drug program includes some meaningful updates: a $2,100 annual out-of-pocket cap on Part D costs, a maximum Part D deductible of $615, and the optional Medicare Prescription Payment Plan, which lets you spread drug costs across the year in monthly installments. In 2027, the out-of-pocket cap rises to $2,400 and the maximum Part D deductible is $700. The old coverage gap ("donut hole") has been eliminated as of 2025.

Higher earners should also know about IRMAA — an income-related surcharge that starts above $109,000 for single filers in 2026 and affects both Part B and Part D premiums.

Local context for Benton

Benton is in Saline County, where Medicare beneficiaries have a range of Original Medicare, Medicare Advantage, and Part D options available. Plan availability is set at the county level, so what's offered in Benton is the same as what's offered elsewhere in Saline County. If you decide to move from employer coverage to Medicare, the Annual Enrollment Period (October 15 – December 7) and the Medicare Advantage Open Enrollment Period (January 1 – March 31) are the main windows to compare choices — though your Special Enrollment Period tied to leaving your job usually takes priority.