Medicare 2026

How company size shapes Medicare choices in Blue Springs

BLUE SPRINGS, Mo. — More people near retirement age are staying on the job past 65, and that leaves a common question hanging: do you have to sign up for Medicare right away, or can you keep your employer's health plan and wait? For many Blue Springs workers, the answer depends on the size of the company you work for — and getting it wrong can cost you for the rest of your life in the form of late penalties.

Here is a plain-English guide to how Medicare fits with a job you still hold, based on rules published by the Centers for Medicare & Medicaid Services (CMS) at medicare.gov.

Part A at 65: usually an easy call

Part A (hospital insurance) is premium-free for most people who paid Medicare taxes for at least 10 years of work. Because it does not cost you a monthly premium, many workers sign up for 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 office before you enroll.

Part B: the decision that depends on your employer's size

Part B (doctor and outpatient care) has a monthly premium, so the timing decision matters more. The federal rules turn on how many people work at your company.

Fewer than 20 employees. Medicare is generally the primary payer at 65. If you don't sign up for Part B, your employer plan may pay very little — or nothing — for services Medicare would have covered. Most workers at small employers should enroll during their Initial Enrollment Period (the 7 months around their 65th birthday).

20 or more employees. Your employer's group health plan is generally the primary payer, and Medicare is secondary. You can usually delay Part B while you (or your spouse) are still actively working and covered by that plan, then sign up later using a Special Enrollment Period — up to 8 months after the job or the coverage ends, whichever comes first.

When in doubt, ask your HR department in writing which plan pays first at 65. Get the answer on paper.

Watch out for the Part B late-enrollment penalty

If you delay Part B without qualifying employer coverage, Medicare can add 10% to your Part B premium for every full 12 months you could have had it but didn't. That surcharge sticks with you for as long as you have Part B — not just a year or two.

Two situations trip people up the most:

• COBRA is not "active" coverage. Once your job ends, COBRA does not protect you from the Part B late penalty. Your 8-month Special Enrollment Period starts when the job ends, not when COBRA runs out.
• Retiree health plans are not active coverage either. If you retire and roll onto a retiree plan, you generally need to enroll in Part B on time.

Part D and prescriptions while you're still working

If your job's health plan includes drug coverage, check each year whether it is "creditable" — meaning it's expected to pay, on average, at least as much as a standard Medicare drug plan. Your plan is required to send you a notice each year that says yes or no. Keep those letters.

If your job coverage is creditable, you can delay Part D without a penalty. If it is not, and you go more than 63 days without creditable drug coverage, a Part D late penalty can be added to your premium later — permanently.

A few program facts to keep in mind once you do move to Medicare drug coverage:

• Part D has an out-of-pocket cap on covered drugs of $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap is gone — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy counter.
• IRMAA — an income-based surcharge on Part B and Part D — starts above $109,000 in income for a single filer in 2026.

What Blue Springs residents can do locally

Blue Springs is in Jackson County, where Medicare beneficiaries have a broad set of Medicare Advantage and stand-alone Part D options to compare once they're ready to enroll. Plan availability is set at the county level, not by city, so your neighbor across town in the same ZIP code likely sees the same choices you do.

Two dates worth marking:

• Annual Enrollment Period: Oct. 15 – Dec. 7, when you can join, switch, or drop Medicare Advantage and Part D plans for the following year.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31, when people already in a Medicare Advantage plan get one chance to switch or return to Original Medicare.

For unbiased, one-on-one help, Missouri's State Health Insurance Assistance Program (CLAIM) offers free counseling to Medicare beneficiaries and their families. You can also call 1-800-MEDICARE (1-800-633-4227) or visit medicare.gov.