Medicare Advantage
Medicare and Employer Coverage: How They Fit in Dallas
People in Dallas can choose from 84 Medicare Advantage plans for 2027, against 93 this year. 29 of this year’s plans are gone, 20 are new to Dallas County, and 31 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.
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DALLAS — Turning 65 while still clocking in at a Dallas office, hospital, or job site raises a fair question: Do you have to sign up for Medicare right now, or can you stick with the health plan from work?
Key takeaways
- Whether you need to sign up for Medicare at 65 while still working depends mainly on your employer's size and the type of coverage you have.
- If you're contributing to a Health Savings Account (HSA), you and your employer must stop putting money in once your Part A starts, though you can still spend what's already saved.
- COBRA and retiree coverage don't count as active employer coverage, so the Medicare enrollment clock keeps running if you're on COBRA at 65.
- In 2026, Part B and Part D income-related surcharges (IRMAA) start for single filers with income above $109,000, based on your tax return from two years earlier.
The short answer is it depends — mostly on how big your employer is, what kind of coverage you have, and how the two programs are supposed to work together. Here's a plain-English look at how to think it through.
Start with the size of your employer
Medicare uses employer size to decide which coverage pays first.
- 20 or more employees: Your group health plan usually pays first, and Medicare pays second if you enroll.
- Fewer than 20 employees: Medicare typically pays first, and your job's plan pays second. In that case, delaying Medicare Part B can leave you with big gaps, because your employer plan may only cover what Medicare would have paid.
If you're not sure which category your employer falls into, ask your HR or benefits office in writing. This one detail shapes almost every decision that follows.
Part A is usually an easy call
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, enrolling in Part A at 65 is often a low-risk move — it can pick up some hospital costs your employer plan doesn't cover.
One important exception: If you contribute to a Health Savings Account (HSA), you (and your employer) must stop contributing the month your Part A begins. You can still spend money already in the HSA, but new deposits aren't allowed once you're on Medicare. Many Dallas workers delay Part A specifically to keep funding an HSA.
Part B is the bigger decision
Part B (doctor and outpatient care) has a monthly premium, so many people with strong job coverage delay it. The rules to know:
- If your employer has 20+ employees and offers creditable coverage, you can generally delay Part B without a late penalty.
- When your job or job-based coverage ends, you get an 8-month Special Enrollment Period to sign up for Part B without penalty.
- If you delay Part B without qualifying coverage, you can face a lifelong late-enrollment penalty added to your premium.
COBRA and retiree coverage do not count as active employer coverage for this purpose. If you go on COBRA at 65, the Medicare clock is still ticking.
Don't forget Part D — even if you're still working
Part D covers prescription drugs. If your employer plan includes drug coverage that Medicare considers "creditable" (at least as good as Part D on average), you can delay Part D without penalty. Your plan should send you a creditable coverage notice each year — keep it.
A few Part D facts worth knowing whenever you do enroll:
- The out-of-pocket cap for covered drugs is $2,100 in 2026 and $2,400 in 2027.
- The maximum deductible any Part D plan can charge is $615 in 2026 and $700 in 2027.
- The old "donut hole" coverage gap is gone — Part D now has three simpler phases.
- The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly payments instead of paying big amounts at the pharmacy counter.
What's available in the Dallas area
Dallas is in Dallas County, where Medicare beneficiaries generally have a wide range of stand-alone Part D plans and Medicare Advantage plans to compare when the time comes. Availability and specific plan details are set at the county level and change each year, so the right way to see current options is to use the Plan Finder at Medicare.gov and enter your ZIP code.
If your income is on the higher end, also keep IRMAA in mind. In 2026, income-related surcharges on Part B and Part D premiums begin above $109,000 for a single filer (based on your tax return from two years earlier).
Key dates to circle
- Initial Enrollment Period: the 7-month window around your 65th birthday month.
- Special Enrollment Period: up to 8 months after job-based coverage ends to sign up for Part B.
- Annual Enrollment Period: Oct. 15 – Dec. 7 each year to join, switch, or drop Part D or Medicare Advantage plans.
- Medicare Advantage Open Enrollment: Jan. 1 – March 31 to change or leave a Medicare Advantage plan.
How to actually decide
A useful order of questions for a Dallas worker turning 65:
1. Does my employer have 20+ employees? 2. Is my current drug coverage creditable? 3. Am I contributing to an HSA I want to keep funding? 4. What would I actually pay under my job plan vs. Medicare + a supplement or Advantage plan? 5. When am I likely to retire?
Once you have answers, compare in writing. Your HR department and Medicare's official tools can each fill in part of the picture.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Dallas County
(MA penetration in Dallas County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
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The parts of Medicare
Good to know
Frequently asked questions
Q: I'm 65, still working, and my employer has 300 people. Do I have to enroll in Medicare?
Q: My company only has 12 employees. Should I still delay Part B?
Q: Does COBRA count as employer coverage for delaying Medicare?
- CMS — MA/Part D Landscape & Plan Finder data
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.