Medicare 2026

Still Working at 65 on Bainbridge? How Medicare Fits In

# Still working at 65? How Medicare coordinates with employer…

BAINBRIDGE ISLAND, Wash. — Turning 65 used to mean retirement was right around the corner. Today, plenty of Bainbridge Island residents are still clocking in — at the shipyard, at a downtown Winslow shop, at a Seattle office reached by the 6:20 a.m. ferry, or from a home desk overlooking Eagle Harbor. If that's you, the big question is usually the same: do I have to sign up for Medicare at 65, or can I stay on my employer's health plan?

The short answer is that it depends on the size of your employer — and getting the timing right matters more than most people realize.

Who pays first: your employer plan or Medicare?

Medicare uses "coordination of benefits" rules to decide which insurer pays first when you have both.

• Employer has 20 or more employees: The group health plan is generally the primary payer, and Medicare pays second.
• Employer has fewer than 20 employees: Medicare is generally primary, and the employer plan pays second.

That second rule catches a lot of people off guard. If you work for a small Bainbridge business — a café, a design studio, a nonprofit — you likely need to enroll in Medicare Parts A and B at 65 so you don't end up with big gaps in coverage.

If you're not sure which category you fall into, ask your HR contact or benefits administrator in writing.

Part A at 65: usually a simple yes

Most people qualify for premium‑free Part A (hospital insurance) at 65 based on their own or a spouse's work history. Because there's no monthly premium, many workers sign up for Part A even while keeping their employer plan.

One important exception: if you contribute to a Health Savings Account (HSA), you cannot keep making HSA contributions once you enroll in any part of Medicare, including Part A. If your HSA matters to you, talk to your benefits office before you enroll.

Part B: when to delay, when not to

Part B (doctor visits and outpatient care) has a monthly premium, so many people working past 65 choose to delay it while they have solid employer coverage.

You can generally delay Part B without a late penalty if:

• Your employer has 20 or more employees, and
• You (or your spouse) are actively working, and
• You have health coverage through that current employer.

When the job or the coverage ends, you get a Special Enrollment Period of up to 8 months to sign up for Part B without a penalty. COBRA and retiree coverage do not count as active employer coverage for this rule — a common and costly mix‑up.

Part D and creditable drug coverage

Part D is prescription drug coverage. If you go 63 days or more without "creditable" drug coverage after you're first eligible, you can face a lifetime late enrollment penalty added to your Part D premium.

Each year, your employer or union plan must send you a notice telling you whether its drug coverage is creditable — meaning it's expected to pay, on average, at least as much as a standard Medicare drug plan. Keep those notices. If you eventually join a Part D plan, you may need to prove you had creditable coverage.

For 2026, Medicare drug coverage has a $2,100 annual out‑of‑pocket cap, a maximum deductible of $615, and no more coverage gap (the old "donut hole" was eliminated in 2025). There's also the optional Medicare Prescription Payment Plan, which lets you spread your drug costs across the year in monthly installments instead of paying at the pharmacy counter.

What Bainbridge Island residents should know locally

Bainbridge Island is in Kitsap County, where Medicare plan availability is set at the county level rather than by city or ZIP code. That means your Original Medicare, Medicare Advantage, Medigap, and Part D options are the same whether you live in Winslow, Rolling Bay, or Lynwood Center.

If you're weighing whether to keep employer coverage or move to Medicare, mark these dates:

• October 15 – December 7: Medicare Annual Enrollment Period, when you can join, switch, or drop Medicare Advantage and Part D plans.
• January 1 – March 31: Medicare Advantage Open Enrollment Period, for people already in a Medicare Advantage plan who want to change.

Higher earners should also know about IRMAA — an income‑related surcharge added to Part B and Part D premiums. For 2026, it begins above $109,000 in income for a single filer (based on your tax return from two years earlier).

A simple pre‑enrollment checklist

Before you make any changes, gather:

1. Confirmation from HR of how many employees your company has and whether your drug coverage is creditable. 2. Your Medicare eligibility date (usually the first day of the month you turn 65). 3. A list of your doctors, medications, and any specialists you see off‑island in Seattle or Silverdale. 4. Your Social Security or Railroad Retirement information, if you're already receiving benefits.

Then call a neutral, no‑cost source before signing anything.