Medicare Part D

Still Working at 65 in Aurora? How Medicare Fits With Job Coverage

AURORA, Ill. — More people are working past 65 than ever, and that raises a very practical question here in the Fox Valley: If you already have health insurance through your job, do you also need to sign up for Medicare? The answer depends on your employer's size, your income, and your prescription needs — and getting it wrong can cost you for years.

Here's a plain-English guide to how the two systems fit together.

Start With One Question: How Big Is the Employer?

The size of your (or your spouse's) employer is the single biggest factor in this decision.

• 20 or more employees: The employer plan is usually the primary payer, and Medicare is secondary. You can generally delay Medicare Part B without a late penalty and keep your job coverage.
• Fewer than 20 employees: Medicare typically becomes the primary payer at 65. In that case, you usually need to enroll in Part A and Part B on time, or the employer plan may pay very little.

If you're unsure which category your employer falls into, ask your HR or benefits office in writing. It's the single most important conversation to have before your 65th birthday.

Part A Is Usually a Safe "Yes"

Most people qualify for premium-free Part A (hospital insurance) because they or a spouse paid Medicare taxes for at least 10 years. Since it costs nothing in premiums, many Aurora workers enroll in Part A at 65 even if they keep employer coverage.

One important exception: If you contribute to a Health Savings Account (HSA), you must stop HSA contributions once any part of Medicare (including Part A) starts. Enrolling in Part A is also retroactive up to six months, so plan the timing carefully with your benefits team.

Part B: The Decision That Trips People Up

Part B covers doctor visits and outpatient care, and it has a monthly premium. Whether to enroll while still working comes down to:

1. Employer size (see above). 2. How your plan coordinates with Medicare — some employer plans require you to take Part B at 65 even if the rules say you don't have to. 3. Cost comparison — for higher earners, the Part B premium can be significantly more. In 2026, IRMAA surcharges begin above $109,000 in income for a single filer.

If you delay Part B correctly through creditable employer coverage, you'll get an 8-month Special Enrollment Period to sign up after that job coverage ends — no late penalty.

Don't Overlook Part D (Prescription Drugs)

Even if you keep employer coverage, check whether its drug benefit is "creditable" — meaning it's at least as good as Medicare's. Your plan is required to send you a notice each year. Keep it.

If your drug coverage isn't creditable and you go more than 63 days without a Part D plan, you can owe a permanent late-enrollment penalty when you finally sign up.

A few Part D facts worth knowing for 2026 and 2027:

• The out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027 — a ceiling on what you pay for covered drugs in a year.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap has been eliminated as of 2025; the benefit now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments if you choose.

What's Available Around Aurora

Aurora sits in Kane County, and plan availability under Medicare is set at the county level — not the city level. That means the number of Medicare Advantage plans, Part D plans, and Medigap options offered to a resident on the east side of Aurora (which crosses into DuPage, Kendall, and Will counties) can differ from a neighbor a few blocks away.

Before comparing anything, confirm which county your address is in. The Medicare Plan Finder at medicare.gov will show you the plans available at your specific ZIP code.

Key Dates to Circle

• Initial Enrollment Period: The 7-month window around your 65th birthday.
• Special Enrollment Period: 8 months after employer coverage ends, for Part B.
• Annual Enrollment Period: October 15 – December 7 each year (for Part D and Medicare Advantage changes).
• Medicare Advantage Open Enrollment: January 1 – March 31 (for switching or dropping an Advantage plan).