Medicare 2026

Working past 65 in Port St. Lucie? How job coverage and Medicare fit together

PORT ST. LUCIE, Fla. — More Floridians are staying on the job past 65, and that raises a practical question: do you need to sign up for Medicare right away, or can you stick with the health plan at work? The answer depends on the size of your employer, the kind of coverage you already have, and a few deadlines that are easy to miss.

Here is a plain-English guide to how Medicare coordinates with employer coverage while you are still working in Port St. Lucie, which is in St. Lucie County.

First, know who pays first

Medicare uses rules called "coordination of benefits" to decide which plan pays your medical bills first. That order is set mostly by the size of your employer.

• If your employer (or your spouse's employer, if you are covered through them) has 20 or more employees, the group health plan is the primary payer and Medicare is secondary.
• If your employer has fewer than 20 employees, Medicare is usually the primary payer, and the job plan pays second.

This matters because if Medicare is supposed to be primary and you did not sign up, the group plan may not cover much — leaving you with big bills. If you work for a smaller employer in the Treasure Coast area, ask your benefits office in writing how they coordinate with Medicare.

Part A at 65: usually a yes

Part A covers hospital stays, and most people qualify for it with no monthly premium because of the payroll taxes they paid while working. For that reason, many people enroll in Part A at 65 even if they keep their job coverage.

One important exception: if you contribute to a Health Savings Account (HSA), you cannot keep adding money to it once you enroll in any part of Medicare, including Part A. If your HSA matters to you, talk with your benefits team before signing up.

Part B: the decision that trips people up

Part B covers doctor visits and outpatient care, and it has a monthly premium. If you have solid employer coverage from a large employer, you can usually delay Part B without a penalty and pick it up later.

When your job or your job-based coverage ends, you get a Special Enrollment Period of up to 8 months to sign up for Part B. Enroll during that window and there is no late penalty. Miss it, and you could pay a higher Part B premium for the rest of your life — and wait months for coverage to start.

If your employer is small (under 20 workers), do not delay. In most cases you need Part B at 65 for your care to be covered properly.

Part D and your work drug plan

Employer plans usually include prescription drug coverage. Each year, your plan should send you a notice telling you whether that coverage is "creditable" — meaning it is at least as good as a standard Medicare Part D plan.

• If your drug coverage is creditable, you can wait to join a Part D plan without a late penalty.
• If it is not creditable and you go more than 63 days without Part D, you may owe a penalty added to your Part D premium later.

For 2026, Medicare's drug benefit has a $2,100 out-of-pocket cap, a maximum deductible of $615, and no coverage gap (the old "donut hole" was eliminated in 2025). There is also an optional Medicare Prescription Payment Plan that spreads drug costs across the year in monthly amounts.

What about Medicare Advantage or Medigap?

You cannot use an employer plan and a Medicare Advantage plan to double up in a helpful way, and you generally cannot buy a new Medigap policy while relying on employer coverage as primary. Most people wait until they leave the job — or their employer plan ends — before shopping Medicare Advantage or Medigap.

Port St. Lucie is in St. Lucie County, where Medicare Advantage and Part D plan choices are set at the county level. When you are ready to compare, you can see every plan available in your ZIP code on medicare.gov's Plan Finder.

Key dates to remember:

• Annual Enrollment Period: October 15 – December 7 (choose or change Medicare Advantage and Part D).
• Medicare Advantage Open Enrollment: January 1 – March 31 (switch or drop an Advantage plan).

A note on higher-income workers

If you are still earning a good salary, keep an eye on IRMAA — an income-related surcharge added to Part B and Part D premiums. For 2026, IRMAA begins for single filers with income above $109,000 (based on your tax return from two years earlier). It is not a reason to skip Medicare, but it is worth factoring into your timing.