Medicare Part D

Still Working at 65? How to Time Medicare in Indianapolis

INDIANAPOLIS — Turning 65 while you're still on the job can feel like a pop quiz you didn't study for. Do you sign up for Medicare now? Wait until you retire? Will you get fined if you guess wrong?

The good news: for most working Hoosiers, the rules are clearer than they look. But a few small missteps can lead to lifelong penalties or a gap in coverage. Here's how to think it through.

First, know what "still working" really means for Medicare

Medicare cares about two things: how big your employer is, and whether your health coverage counts as "creditable."

• If your employer has 20 or more employees, your job-based health plan usually pays first, and Medicare pays second — if you enroll.
• If your employer has fewer than 20 employees, Medicare typically pays first. In that case, you generally need to enroll in Part A and Part B at 65, or you could be left with big gaps.
• COBRA and retiree coverage don't count as active employer coverage for delaying Medicare. That trips up a lot of people.

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

Part A is usually a safe "yes" — Part B is the real decision

Most people qualify for premium-free Part A (hospital insurance) because they or a spouse paid Medicare taxes long enough. If that's you, signing up at 65 usually doesn't cost anything extra.

One exception: if you contribute to a Health Savings Account (HSA) through work, you and your employer must stop contributing once Medicare (including Part A) starts. Part A can even backdate up to six months. Talk to your benefits team before you enroll if the HSA matters to you.

Part B (doctor and outpatient care) has a monthly premium. If your employer coverage is solid and your company is large, many people delay Part B until they retire — and that's allowed, without penalty, as long as you have qualifying employer coverage.

The Special Enrollment Period is your safety net

When you eventually leave your job or lose employer coverage, you get an 8-month Special Enrollment Period (SEP) to sign up for Part B without a late penalty. For Part D drug coverage, the window is shorter — 63 days.

To avoid the Part B late enrollment penalty (which can add 10% to your premium for every 12 months you were eligible but not enrolled — for life), you'll need proof of prior creditable coverage. Ask HR for a CMS-L564 form when you leave.

Don't wait until the last week. Coverage doesn't always start the day you apply.

Drug coverage: don't overlook Part D

If your employer plan includes prescription drug coverage that Medicare considers "creditable," you can skip Part D for now. Your plan is required to send you a creditable coverage notice each year — usually before October 15. Keep those letters.

If your work drug coverage is not creditable and you go more than 63 days without Part D, you can face a lifelong Part D penalty when you finally enroll.

A few numbers worth knowing:

• Part D out-of-pocket costs are capped at $2,100 for the year.
• The maximum Part D deductible is $615.
• The old "donut hole" coverage gap has been eliminated as of 2025 — Part D now has three phases.
• If you're worried about big drug bills hitting all at once, the Medicare Prescription Payment Plan lets you spread costs across the year in monthly installments.

What's available around Indianapolis

Indianapolis is in Marion County, where Medicare Advantage and Part D plan availability is set at the county level, not the city level. That means when you compare plans on medicare.gov, you'll see options based on your ZIP code and Marion County. If you live in a neighboring county — Hamilton, Hendricks, Johnson, Hancock, Boone, Morgan, or Shelby — your plan choices may look different, even if you work in downtown Indy.

Availability and details change every year. Use the Plan Finder at medicare.gov to see current options for your specific address.

Key dates to circle

• Initial Enrollment Period: the 7 months around your 65th birthday (3 before, the month of, 3 after).
• Special Enrollment Period: up to 8 months after job-based coverage ends for Part B; 63 days for Part D.
• Annual Enrollment Period: October 15 – December 7, when anyone with Medicare can change Advantage or Part D plans for the next year.
• Medicare Advantage Open Enrollment: January 1 – March 31, a one-time chance to switch Advantage plans or return to Original Medicare.

One more note for higher earners: IRMAA surcharges — extra amounts added to Part B and Part D premiums — kick in for single filers with income above $109,000 in 2026 (higher thresholds for joint filers). Retirement year income changes can trigger IRMAA, but you can appeal after a "life-changing event" like retirement.