Signing up and deadlines
Do I need to sign up for Medicare at 65 if I'm still working?
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Short answer
Not always: if you or your spouse are actively working and covered by that employer's group health plan, you can usually delay Medicare Part B without a penalty and sign up within 8 months after the job or the coverage ends.
The employer's size matters: with 20 or more employees the employer plan generally pays first, but with fewer than 20 employees Medicare generally pays first, so you usually need Parts A and B at 65.
COBRA, retiree coverage and Marketplace plans are not coverage from current work, so they don't let you delay Part B without risking a penalty.
| Fact | Figure | Source |
|---|---|---|
| Employer with 20 or more employees | The group health plan generally pays first; Part B can wait | CMS |
| Employer with fewer than 20 employees | Medicare generally pays first; sign up for Parts A and B | CMS |
| Window to sign up after work ends | 8 months after the job or the coverage ends, whichever is first | Medicare.gov |
| Health Savings Account | Stop contributions 6 months before you apply for Medicare or Social Security | Medicare.gov |
| COBRA and retiree coverage | Don't count as current-work coverage for delaying Part B | Medicare.gov |
| Drug coverage | Creditable job-based drug coverage lets you delay Part D without a penalty | Medicare.gov |
Does the size of my employer matter?
Yes. When an employer has 20 or more employees, its group health plan based on your (or your spouse's) current employment generally pays first and Medicare second, so many people delay Part B. When the employer has fewer than 20 employees, Medicare generally pays first and the employer plan second; without Part B you could be left with large unpaid bills, so most people in that situation sign up for Parts A and B at 65. Ask the plan's benefits administrator how it works with Medicare.
Should I take Part A while I'm still working?
Part A is premium-free for most people, so many take it at 65 even with job coverage. The exception is a Health Savings Account: once you have any part of Medicare, you can't contribute to an HSA. Part A coverage can start up to 6 months before the month you apply (but no earlier than the month you turn 65), so Medicare.gov advises stopping HSA contributions 6 months before you apply for Medicare or Social Security benefits.
How do I sign up when I stop working?
You get an 8-month Special Enrollment Period that starts the month after the employment or the group coverage ends, whichever comes first. Apply for Part B with form CMS-40B and have your employer complete form CMS-L564 to prove you had coverage. Sign up before the job coverage ends to avoid a gap: coverage generally starts the month after you sign up.
What about COBRA, retiree or Marketplace coverage?
None of these is coverage from current employment. Your 8-month window starts when the job ends, even if you take COBRA, and COBRA doesn't extend it. If you get Medicare while on COBRA, Medicare pays first. Marketplace plans don't give you a Part B Special Enrollment Period later, and Marketplace premium tax credits generally end once you qualify for premium-free Part A.
Do I need Part D if I have drug coverage at work?
Not if the coverage is creditable, meaning it's expected to pay at least as much as standard Medicare drug coverage. Your employer or union sends a notice each year saying whether it is. Keep the notices: they protect you from the Part D late enrollment penalty when you join a plan later.
What happens to my Medigap window if I delay Part B?
Your 6-month Medigap Open Enrollment Period starts when you're 65 or older and enrolled in Part B, so delaying Part B also delays it. That keeps the window open for when you retire and need a Medigap policy.
Good to know
More questions people ask
Can I keep contributing to my HSA after 65?
My spouse is still working. Can I delay Part B on their coverage?
Is retiree health coverage enough to delay Part B?
I'm self-employed. Can I delay Medicare?
Related questions
- Medicare.gov: Working past 65
- Medicare.gov: When can I sign up for Medicare?
- Medicare.gov: Avoid late enrollment penalties
- Medicare.gov: When does Medicare coverage start?
Figures are Medicare’s, set nationally, and were checked against these pages on October 2026. For your own situation, contact Medicare.gov or 1-800-MEDICARE (TTY 1-877-486-2048).
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This page was last updated: October 2026.