Medicare 2026

Medicare enrollment while working past 65 in Delaware, Ohio

DELAWARE, Ohio — Turning 65 while you're still on the job can feel like a puzzle. You're eligible for Medicare, but you already have health coverage through work. Do you sign up now? Wait? Drop your employer plan? The answer depends on the size of your employer — and getting it wrong can mean lifelong penalties or a gap in coverage.

Here in Delaware, part of Delaware County, more people are working past 65 than a generation ago. That makes coordinating Medicare with a job-based plan one of the most common — and most confusing — questions local retirees-in-waiting are asking.

First, know which coverage pays first

Medicare uses "coordination of benefits" rules to decide which insurer pays your medical bills first. According to Medicare.gov, the rule usually turns on your employer's size:

• 20 or more employees: Your group health plan is the primary payer. Medicare pays second.
• Fewer than 20 employees: Medicare is generally primary, and your employer plan pays second.

This matters a lot. If Medicare is supposed to pay first and you haven't enrolled, your employer plan may pay very little — leaving you with big bills.

Should you take Part A at 65?

Most people qualify for premium-free Part A (hospital insurance) at 65 because they or a spouse paid Medicare taxes for at least 10 years. Since it costs nothing in premiums, many workers sign up for Part A even while keeping their job coverage.

There's one big exception: if you contribute to a Health Savings Account (HSA), you must stop HSA contributions once you enroll in any part of Medicare. If you want to keep contributing, you'll need to delay Part A — and that means delaying your Social Security claim too, since starting Social Security automatically enrolls you in Part A.

What about Part B?

Part B (doctor visits and outpatient care) has a monthly premium, so the decision is trickier. If your employer has 20+ employees and you have solid coverage, you can usually delay Part B without penalty and enroll later through a Special Enrollment Period (SEP).

If your employer has fewer than 20 employees, you generally need to enroll in Part B at 65. Otherwise, you may be left with major gaps in what gets paid.

Ask your HR department for a written statement confirming whether your coverage is considered "creditable" for Medicare purposes. Keep it in a safe place — you may need it later.

The 8-month deadline that trips people up

When your job or your job-based coverage ends — whichever comes first — you have an 8-month Special Enrollment Period to sign up for Part B without a late penalty. COBRA and retiree coverage do not extend this window, even though they may feel like active coverage.

Miss the SEP, and you could face a Part B late enrollment penalty of 10% for every 12 months you were eligible but not enrolled. That penalty is added to your premium for as long as you have Medicare.

Don't forget Part D

Prescription drug coverage has its own rules. If your employer plan includes drug coverage that Medicare considers "creditable," you can delay Part D without penalty. Your plan should send you a notice each year telling you whether it's creditable — hold onto it.

Medicare's Part D program includes an annual out-of-pocket cap on covered drugs of $2,100 in 2026 and $2,400 in 2027, along with a maximum deductible of $615 in 2026 and $700 in 2027. The optional Medicare Prescription Payment Plan also continues, letting you spread drug costs across monthly payments instead of paying large amounts at the pharmacy counter.

Higher earners: watch for IRMAA

If your income is above $109,000 as a single filer (or $218,000 for a couple filing jointly) in 2026, you'll pay an Income-Related Monthly Adjustment Amount (IRMAA) on top of your Part B and Part D premiums. Since Medicare looks at your tax return from two years earlier, working longer at a higher salary can affect what you pay once you do enroll.

Mark your calendar

Even if you delay Medicare, know the key dates:

• Initial Enrollment Period: the 7-month window around your 65th birthday.
• Special Enrollment Period: up to 8 months after job coverage ends.
• Annual Enrollment Period: October 15 – December 7 each year.
• Medicare Advantage Open Enrollment: January 1 – March 31.