Medicare 2026

Griffin at 65 and Still Working? Avoid These Medicare Missteps

Turning 65 in Griffin while you're still on the job can feel like a puzzle. You get letters about Medicare, your HR department gives you a shrug, and friends offer conflicting advice. The good news: coordinating Medicare with employer coverage is manageable once you understand a few rules. The bad news: a wrong move can trigger lifetime penalties or leave you without drug coverage. Here's how to think it through.

First question: how big is your employer?

Medicare treats employer coverage differently depending on company size, and this single fact drives most of your decisions.

If your employer (or your spouse's employer, if you're covered through them) has 20 or more employees, the group health plan is generally the primary payer, and Medicare is secondary. You can usually delay Part B without penalty and stay on the job plan.

If the employer has fewer than 20 employees, Medicare typically becomes the primary payer at 65. That means you usually need to enroll in Part A and Part B on time, or you could be stuck with big out-of-pocket bills the employer plan won't cover.

Ask your benefits administrator, in writing, whether your plan is primary or secondary once you turn 65. Don't guess.

Part A: usually a simple "yes"

Most people qualify for premium-free Part A because they or their spouse paid Medicare taxes for at least 10 years. Since it costs nothing in premiums, many still-working Griffin residents enroll in Part A at 65 as a backstop for hospital costs.

One important exception: if you contribute to a Health Savings Account (HSA), you must stop HSA contributions once any part of Medicare (including Part A) begins. Enrolling in Medicare while still contributing can create a tax problem. If your HSA matters to you, talk to your benefits team before signing up.

Part B: the piece that trips people up

Part B has a monthly premium, so many people delay it while covered by a large employer plan. That's often fine — but only if your employer coverage counts as "current employment" coverage from an employer with 20+ workers. COBRA and retiree coverage do not count for this purpose, even though they feel like employer plans.

If you delay Part B without qualifying coverage, you can face a 10% penalty for every 12 months you were eligible but not enrolled — and that penalty lasts as long as you have Part B.

When you do retire or lose the job coverage, you get an eight-month Special Enrollment Period to sign up for Part B without penalty. Don't wait the full eight months, though — coverage doesn't start until the month after you enroll, and you could have a gap.

Part D drug coverage: check your "creditable" letter

Every fall, your employer plan should send a notice telling you whether its drug coverage is "creditable" — meaning it's at least as good as standard Medicare Part D. Keep those letters.

If your employer drug coverage is creditable, you can delay Part D without penalty. If it isn't, and you go more than 63 days without Part D or creditable coverage, you'll owe a lifetime late enrollment penalty when you eventually sign up.

For 2026, standard Part D has a maximum deductible of $615 and a new $2,100 annual out-of-pocket cap on covered drugs. There's also an optional Medicare Prescription Payment Plan that lets you spread drug costs across the year in monthly installments.

Griffin and Spalding County: what's available locally

Griffin is in Spalding County, where Medicare beneficiaries have access to Original Medicare plus a range of Medicare Advantage and stand-alone Part D plans offered by private insurers. Plan availability is set at the county level, not the city level, so two neighbors in Griffin see the same menu of options.

You can compare what's available in Spalding County using the Plan Finder at medicare.gov, which lets you enter your prescriptions and preferred doctors to see how different plans would work for your situation.

Timing: your enrollment windows

• Initial Enrollment Period: the 7-month window around your 65th birthday (3 months before, your birthday month, and 3 months after).
• Special Enrollment Period: an 8-month window that starts when your employment or employer coverage ends, whichever comes first.
• Annual Enrollment Period: October 15 – December 7 each year, for changes to Medicare Advantage and Part D.
• Medicare Advantage Open Enrollment: January 1 – March 31, for people already in a Medicare Advantage plan who want to switch.

One more figure to know: IRMAA — an income-related surcharge on Part B and Part D — kicks in for single filers with income above $109,000 in 2026 (higher thresholds for joint filers). If you're a high earner still working, this may factor into your timing.