Medicare 2026

Medicare and Employer Coverage for Plainfield Workers at 65

Turning 65 while you're still on the job can raise a big question: do you sign up for Medicare now, or wait? For workers in Plainfield, the answer depends on the size of your employer, how your current coverage works, and a few deadlines you don't want to miss.

Start with employer size

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

• 20 or more employees: Your group plan is the "primary" payer and Medicare is "secondary." You can usually delay Part B without a penalty.
• Fewer than 20 employees: Medicare generally becomes the primary payer at 65. In that case, most people need to enroll in Part A and Part B on time, or the employer plan may not pay much at all.

If you're not sure which category you fall into, ask your HR or benefits office in writing. This is the same question they field from other Plainfield workers turning 65 — you're not the first.

Part A is usually a yes

Part A (hospital insurance) is premium-free for most people who have worked and paid Medicare taxes for at least 10 years. Because there's no monthly cost, many workers sign up at 65 even if they keep their employer plan. Part A can help pick up some hospital costs the group plan doesn't cover.

One big exception: If you contribute to a Health Savings Account (HSA), you must stop HSA contributions before Part A begins. Medicare enrollment — including Part A — makes you ineligible to keep contributing. Talk with your benefits team or a tax advisor about timing.

Part B: the decision that trips people up

Part B (doctor and outpatient coverage) has a monthly premium, so many still-working people ask whether to delay it.

• If your employer coverage is considered "creditable" for Part B (generally, a group plan from an employer with 20+ workers), you can delay Part B without a late penalty.
• When you eventually leave the job or lose that coverage, you get an 8-month Special Enrollment Period to sign up for Part B without penalty.
• If you miss that window, you may face a lifetime late-enrollment penalty and gaps in coverage.

Retiree coverage, COBRA, and marketplace plans do not count as active employer coverage for this purpose. If you're only on COBRA at 65, you should still enroll in Part B on time.

Don't forget Part D — prescription drugs

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

Part D also comes with some meaningful protections built in by law. Figures shown are for 2026 and 2027 where confirmed:

• A annual out-of-pocket cap on covered drugs of $2,100 in 2026 and $2,400 in 2027.
• A maximum deductible of $615 in 2026 and $700 in 2027.
• The old coverage gap ("donut hole") is gone as of 2025.
• An optional Medicare Prescription Payment Plan lets you spread drug costs into monthly installments.

Watch your income — IRMAA

Higher-income workers should know about IRMAA, an income-related surcharge on Part B and Part D premiums. In 2026, it kicks in above $109,000 in income for a single filer (higher for joint filers). If you're still earning a full-time salary, you may pay more than the standard premium once you enroll — something to plan for, not fear.

When you're ready to leave employer coverage

When your job ends or your group plan drops, you'll want to line up:

1. Part B enrollment through Social Security during your 8-month Special Enrollment Period. 2. Part D or Medicare Advantage during your 2-month Special Enrollment Period tied to losing employer drug coverage.

Plainfield is in Union County, where multiple insurance carriers sell Medicare Advantage and stand-alone Part D plans. You can compare what's available side-by-side using the plan finder at medicare.gov. If you'd rather stick with Original Medicare, you can also shop for a Medigap (supplement) policy — just note that guaranteed-issue protections have time limits.

Key dates to remember

• Initial Enrollment Period: The 7 months around your 65th birthday.
• Special Enrollment Period (Part B): Up to 8 months after employer coverage ends.
• Annual Enrollment Period: October 15 – December 7 each year.
• Medicare Advantage Open Enrollment: January 1 – March 31 each year.