Medicare 2026

Still Working at 65 in Howell? How Medicare Fits With Job Coverage

# Still Working at 65? How Medicare Coordinates With Employer Coverage

HOWELL, N.J. — Turning 65 used to mean handing in your ID badge and heading straight into retirement. Not anymore. Plenty of folks in Howell are still clocking in at 65 — and that raises a real question: do you sign up for Medicare, stick with your employer plan, or find a way to use both?

The answer depends on a few details about your job, your spouse's coverage, and the size of your employer. Here's how to think it through before you make a decision you can't easily undo.

Start With One Key Question: How Big Is the Employer?

Medicare's rules for working past 65 hinge on the size of the employer offering your health coverage.

• 20 or more employees: Your employer's group health plan usually pays first, and Medicare pays second. In most cases you can delay signing up for Part B without a penalty later.
• Fewer than 20 employees: Medicare typically pays first, and the employer plan pays second. If you don't enroll in Medicare on time, your employer plan may leave big gaps — because it assumes Medicare is picking up its share.

If you work for a small employer in Howell — a local shop, a small practice, a family business — this rule catches people off guard. Ask your HR or benefits contact, in writing, whether Medicare should be primary.

Part A Is Usually an Easy "Yes"

Most people qualify for premium-free Part A (hospital insurance) based on their own or a spouse's work history. Because there's no monthly premium, many workers enroll in Part A at 65 even if they keep employer coverage.

One important exception: if you contribute to a Health Savings Account (HSA), you can't keep adding 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 signing up.

Part B Is the Bigger Decision

Part B (doctor and outpatient care) has a monthly premium, so the choice to enroll — or to delay — is where most working folks pause.

You can generally delay Part B without a late penalty if your employer coverage counts as "creditable" and is based on current employment (not retiree coverage or COBRA). When you eventually leave the job, you get an eight-month Special Enrollment Period to sign up for Part B without a penalty.

Two cautions:

• Retiree coverage and COBRA do not count as active employer coverage for delaying Part B. Missing your window here can mean a lifelong premium penalty.
• Even large-employer coverage sometimes works better as secondary to Medicare. Ask HR for the plan's "Medicare coordination" details.

What About Part D and Prescription Drugs?

If your employer plan includes drug coverage that Medicare considers "creditable," you can delay Part D with no penalty. Your plan should send you a creditable coverage notice each year — keep it.

A few 2026 numbers worth knowing when you eventually move to Medicare drug coverage:

• Part D out-of-pocket costs are capped at $2,100 for the year.
• The maximum Part D deductible is $615.
• The old "donut hole" is gone — Part D now has three simpler phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts, instead of paying a big bill at the pharmacy counter.

Higher Earners: Watch for IRMAA

If your income is above $109,000 as a single filer (or $218,000 filing jointly) in 2026, you'll pay an income-related surcharge, called IRMAA, on top of standard Part B and Part D premiums. That's based on your tax return from two years earlier. Working past 65 often means higher income — so this is worth checking before you enroll.

What's Available Locally

Howell is in Monmouth County, where a wide range of Medicare Advantage and stand-alone Part D plans are offered each year. Plan availability is set at the county level, not by town, so a neighbor in Freehold or Wall sees the same menu you do. If and when you leave your employer plan, you'll compare those options during the Annual Enrollment Period, Oct. 15 – Dec. 7, or use the Medicare Advantage Open Enrollment Period, Jan. 1 – March 31, to switch Advantage plans.