Medicare 2026

How Medicare Fits Alongside Workplace Coverage in Newport

NEWPORT, R.I. — Turning 65 while you're still clocking in doesn't mean you have to drop your job's health plan and jump straight into Medicare. But it does mean you have some decisions to make — and a few deadlines you don't want to miss.

Still working at 65 in Newport? Here's how Medicare fits in

Whether you're working at a hospital in town, running your own shop on Thames Street, or teaching at a local school, the rules about coordinating Medicare with an employer plan can be confusing. Here's a plain-language walk-through.

The size of your employer matters more than you'd think

The first question isn't about you — it's about your company.

If your employer has 20 or more employees, your group health plan usually pays first, and Medicare pays second. That gives you more flexibility to delay parts of Medicare without a penalty.

If your employer has fewer than 20 employees, Medicare usually pays first, and your group plan pays second. In that case, most people need to enroll in Medicare Parts A and B on time, or they could be left with big gaps in coverage. Your HR office or benefits administrator can confirm which rule applies to you.

Part A is usually a no-brainer

Most people qualify for premium-free Part A (hospital insurance) because they or a spouse paid Medicare taxes long enough while working. If that's you, signing up at 65 typically costs nothing out of pocket and can work alongside your job's plan.

There's one important exception: if you contribute to a Health Savings Account (HSA), you and your employer must stop making contributions once you enroll in any part of Medicare, including Part A. If keeping your HSA is important, talk with your benefits team before enrolling.

Part B is where timing gets tricky

Part B (doctor visits and outpatient care) has a monthly premium, so many people who are still working ask: do I really need this now?

If your employer coverage counts as "creditable" — meaning it's as good as Medicare — you can generally delay Part B without a late penalty. When you eventually leave the job or lose the coverage, you get a Special Enrollment Period of up to 8 months to sign up without a penalty.

If you don't have creditable coverage and you skip Part B, you could face a lifetime late-enrollment penalty added to your premium. That's why it pays to get your employer plan's status in writing before you decide.

Don't forget about Part D (drug coverage)

Your employer plan almost always includes prescription coverage. As long as it's considered creditable, you can delay Part D too. Employers are required to send you a Notice of Creditable Coverage each year — hang onto it. You'll want it when you eventually sign up for a Medicare drug plan.

Medicare drug plans include some important updates worth knowing about when the time comes:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible is $615 in 2026 and $700 in 2027.
• The old "donut hole" coverage gap is gone, replaced with three simpler phases.
• A new Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly installments if you'd like.

What Newport-area retirees should know about local options

Newport is in Newport County, where Medicare Advantage and stand-alone Part D plans are offered through a mix of national and regional carriers. Plan availability is set at the county level, so two neighbors in the same ZIP code will see the same menu of choices.

If and when you're ready to leave your employer plan, you'll have two main paths: 1. Original Medicare (Parts A and B), often paired with a stand-alone Part D drug plan and sometimes a Medigap supplement. 2. Medicare Advantage (Part C), which bundles hospital, medical, and usually drug coverage through a private plan.

The Annual Enrollment Period runs October 15 through December 7 each year. If you're already in a Medicare Advantage plan, there's also a Medicare Advantage Open Enrollment Period from January 1 through March 31 for one switch.

A quick note on higher incomes

If your income is above $109,000 as a single filer (or $218,000 married filing jointly) in 2026, you'll pay an income-related surcharge called IRMAA on top of your Part B and Part D premiums. Because Medicare looks at your tax return from two years ago, some people who are still working — or recently sold a home or a business — get surprised by this. If your income has dropped since then, you can ask Social Security to reconsider using a life-changing event form.