Medicare 2026

Turning 65 in Batavia and Still on the Job? Read This First

# Turning 65 in Batavia and Still on the Job? Read This…

BATAVIA, N.Y. — If you're approaching 65 and still clocking in, you're facing a decision that trips up plenty of workers: sign up for Medicare now, delay it, or piece it together with the health plan you already have. The right answer depends less on your age than on the size of your employer — and getting it wrong can mean lifelong penalties.

Here's how to think it through before your birthday month arrives.

The employer-size rule is the whole ballgame

Medicare's coordination rules hinge on one number: how many people work at your employer.

• Fewer than 20 employees: Medicare is typically the primary payer. That means your job's plan pays second — and if you skipped Part B, you could be stuck paying the share Medicare would have covered.
• 20 or more employees: Your group health plan pays first, and Medicare pays second. Many workers in this group choose to delay Part B and stick with their employer plan until they retire.

Batavia workers should confirm their employer's size and how the group plan coordinates with Medicare before their 65th birthday. Your HR or benefits office can put this in writing.

Part A is often a free add-on — with one big caveat

Most people qualify for premium-free Part A (hospital coverage) based on their work history. Because it costs nothing out of pocket, many people enroll in Part A at 65 even while keeping employer coverage.

The catch: once you're enrolled in any part of Medicare, you can no longer contribute to a Health Savings Account. If your workplace HSA matters to you, weigh that carefully. You can delay Part A too, as long as you're not collecting Social Security.

Don't miss your Special Enrollment Period

When you eventually leave your job — or your employer coverage ends — you get an 8-month Special Enrollment Period to sign up for Part B without a late penalty. That clock starts the month after your employment or group coverage ends, whichever comes first.

Miss that window, and you could face a Part B late-enrollment penalty that sticks with you for as long as you have Medicare. COBRA and retiree coverage do not count as active employer coverage for this rule, so don't lean on them to delay Part B.

What about Part D drug coverage?

If your employer plan includes drug coverage, check each year whether it's considered "creditable" — meaning it pays out at least as much as standard Medicare drug coverage. Your plan is required to send you a notice.

If your coverage is creditable, you can delay Part D without penalty. If it isn't, signing up for a Part D plan on time matters. Medicare drug coverage carries a maximum deductible of $615 in 2026 and $700 in 2027, and the annual cap on what enrollees pay out of pocket for covered drugs is $2,100 in 2026 and $2,400 in 2027. Medicare's optional Prescription Payment Plan also lets you spread those drug costs across the calendar year.

Local context for Genesee County

Batavia sits in Genesee County, where Medicare plan availability — including Medicare Advantage and standalone Part D plans — is set at the county level. When you're ready to compare options, the Medicare Plan Finder at medicare.gov lets you search by ZIP code to see exactly what's offered in your area. Availability and details can change each year, so it pays to look during the Annual Enrollment Period, October 15 through December 7.

A note on higher earners

If your income is above $109,000 as a single filer (or $218,000 filing jointly) in 2026, expect an Income-Related Monthly Adjustment Amount, or IRMAA, added to your Part B and Part D premiums. That's based on your tax return from two years earlier. Still working and earning at that level? Factor IRMAA into your decision about when to start Part B.