Medicare 2026

Why Wilmington Workers Ask About Medicare at 65

WILMINGTON, N.C. — Turning 65 while you're still on the clock? You're in good company. Plenty of workers in Wilmington are staying on the job past 65, and many are asking the same question: do I have to sign up for Medicare now, or can I wait?

The honest answer is, "it depends" — mostly on the size of your employer and the kind of coverage you have. Here's a plain-language walk through how Medicare works alongside a job, so you can make a confident call and avoid a costly late-enrollment penalty.

Start with Part A — it's usually a simple 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, signing up for Part A at 65 is generally low-risk, even if you're still working. It can act as secondary coverage behind your employer plan.

One important exception: if you contribute to a Health Savings Account (HSA), you (and your employer) must stop contributing once Medicare Part A starts. Enrolling in Medicare — including Part A alone — makes you ineligible to add new money to an HSA. You can still spend what's already in there.

Part B is the bigger decision

Part B (doctor visits and outpatient care) has a monthly premium, so most people weigh it more carefully. The right move depends on your employer's size:

• 20 or more employees: Your job's health plan is usually the primary payer, and Medicare would be secondary. Many workers in this situation delay Part B and enroll later without penalty, using a Special Enrollment Period when they retire or lose the job coverage.
• Fewer than 20 employees: Medicare typically becomes the primary payer at 65, whether you enroll or not. If you skip Part B here, your employer plan may pay very little — leaving you exposed. Most people in this group should enroll in Part B at 65.

If you're not sure how your plan works, ask your HR or benefits office directly: "Is our plan primary or secondary to Medicare for employees 65 and older?"

COBRA and retiree coverage do not count as active employer coverage

This trips up a lot of people. Once you leave your job, COBRA and retiree health plans are not considered current employer coverage for Medicare purposes. That means they don't protect you from a Part B late-enrollment penalty, and they don't extend your Special Enrollment Period.

If you're heading into retirement, plan to enroll in Part B before or at the time your active job coverage ends — not when COBRA runs out.

Watch the enrollment windows

A few dates worth writing down:

• Initial Enrollment Period: the 7-month window around your 65th birthday.
• Special Enrollment Period (SEP): if you delayed Part B because of job coverage, you generally get 8 months after that coverage ends (or the job ends, whichever is first) to sign up without a penalty.
• Annual Enrollment Period: Oct. 15 – Dec. 7, for changes to Part D or Medicare Advantage.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31.

The Part B late-enrollment penalty is permanent — it's added to your premium for as long as you have Part B — so getting the timing right matters.

What about Part D and drug costs?

If your job's drug coverage is considered "creditable" (at least as good as standard Medicare drug coverage), you can usually delay Part D without a penalty. Your employer is required to send you a notice each year telling you whether your drug coverage is creditable — hang on to it.

Some Part D figures worth knowing once you do enroll:

• The annual out-of-pocket cap is $2,100 — a first-time hard ceiling on what you pay for covered drugs.
• The maximum deductible is $615.
• The old "donut hole" coverage gap was eliminated in 2025; there are now three simpler phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments, if that helps your budget.

Higher earners should also know about IRMAA — an income-related surcharge on Part B and Part D premiums that kicks in above $109,000 for a single filer in 2026 (higher for joint filers). If you're still drawing a strong paycheck, this can catch you by surprise.

A quick word on local options

If and when you're ready to look at Medicare Advantage or standalone Part D plans, remember that plan availability is set at the county level. Wilmington is in New Hanover County, and the specific plans and carriers offered there change every year. The official plan finder at medicare.gov lets you compare what's available using your ZIP code and your prescription list.