Medicare 2026

Medicare and Employer Coverage in Edina: How They Work Together

EDINA, Minn. — Turning 65 while you're still on the job can feel confusing. Do you sign up for Medicare now? Wait until you retire? Keep your employer plan and skip Medicare for a while? The right answer depends on the size of your employer, the coverage you already have, and a few deadlines you don't want to miss.

Still working at 65? Here's how Medicare fits in

If you live in Edina and are weighing these choices, here's a plain-English guide to coordinating Medicare with the coverage from your job.

Start with the size of your employer

The single most important factor is how many people work at your (or your spouse's) employer.

• 20 or more employees: Your employer plan is usually the primary payer, and Medicare is secondary. Many people in this situation delay Part B without penalty, because the employer coverage counts as "creditable."
• Fewer than 20 employees: Medicare is typically the primary payer. In most cases, you'll want to enroll in Part A and Part B when you're first eligible, or you could be left with big gaps in coverage.

If you're not sure which category you fall into, ask your HR or benefits office in writing. Get their answer in writing, too — it matters if you ever need to prove your coverage was creditable.

Part A is usually an easy "yes"

Most people qualify for premium-free Part A (hospital insurance) because they or a spouse paid Medicare taxes for at least 10 years. If that's you, enrolling in Part A at 65 is often a simple decision — it can help cover hospital costs your employer plan doesn't.

One important exception: if you contribute to a Health Savings Account (HSA), you (and your employer) must stop contributing once you enroll in any part of Medicare, including Part A. If your HSA is valuable to you, talk with your benefits team before signing up.

Part B: enroll now, or delay?

Part B (doctor visits and outpatient care) comes with a monthly premium. Whether to delay it depends on your employer coverage.

• Large employer (20+): You can usually delay Part B while you're actively working and covered. When the job or coverage ends, you get an 8-month Special Enrollment Period to sign up without a late penalty.
• Small employer (fewer than 20): Delaying Part B can leave you underinsured, and you may face a lifelong late-enrollment penalty.
• Retiree coverage or COBRA: These do not count as active employer coverage for Medicare purposes. If you're on COBRA or retiree benefits, you generally need to enroll in Part B on time.

The Part B late-enrollment penalty adds 10% to your premium for each full 12-month period you could have had it but didn't — and it lasts as long as you have Medicare.

Part D and prescription drugs

If your employer plan includes prescription drug coverage that Medicare considers creditable (roughly as good as a standard Part D plan), you can delay Part D without a penalty. Your plan should send you a Creditable Coverage Notice each year — keep it.

A few figures worth knowing when you eventually move to Part D:

• The Part D out-of-pocket cap is $2,100 for 2026.
• The Part D maximum deductible is $615.
• The old coverage gap ("donut hole") is gone as of 2025.
• Medicare's new Prescription Payment Plan lets you spread drug costs across the year in monthly installments if you choose.

What's available in your area

Edina is in Hennepin County, where Medicare beneficiaries can choose from Original Medicare (Parts A and B), stand-alone Part D drug plans, Medicare Advantage plans (which bundle Parts A, B, and usually D), and Medigap (Medicare Supplement) policies to pair with Original Medicare. The exact number of plans changes each year, and availability is set at the county level — not the city level.

You can compare what's offered in Hennepin County using the plan finder at medicare.gov.

Key dates to remember

• Initial Enrollment Period: the 7-month window around your 65th birthday.
• Special Enrollment Period: up to 8 months after employer coverage ends, for Part B.
• Annual Enrollment Period: October 15 – December 7 each year.
• Medicare Advantage Open Enrollment: January 1 – March 31.

Higher earners should also know about IRMAA — an income-related surcharge on Part B and Part D premiums that starts above $109,000 in income for a single filer in 2026 (based on your tax return from two years earlier).