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I will not retire until age 70. Do I still have to sign up for Medicare at age 65?

En español | If you’re over 65 and receive coverage under a group health plan provided by an employer for which you or your spouse actively works, you have the right to delay Medicare enrollment until the job ends or the coverage ends — whichever occurs first. At that point, you’re entitled to a special enrollment period of up to eight months to sign up for Medicare without risking late penalties.  

If the employer has 20 or more employees, the law stipulates that those 65 and older (and their spouses) must be offered exactly the same health benefits that are offered to younger employees (and their spouses). In this situation, the employer cannot require you to sign up for Medicare when you turn 65 or become eligible for Medicare due to disability.  

However, the law does not give the same protection to people who work for smaller employers — those with fewer than 20 employees. In this situation, an employer is allowed (but not obligated) to require you to sign up for Medicare when you become eligible. If so, Medicare would become your primary coverage — meaning that it would settle your medical bills first, and the employer plan would only pay toward services that it covers but Medicare doesn’t. Therefore, if you are required to sign up for Medicare but don’t, you’ll essentially be left with little or no health coverage. So it’s critically important to find out from the employer whether you need to enroll in Medicare. If you do, find out exactly how the employer coverage fits in with Medicare. If you’re told you don’t, get that decision in writing. 

There is one situation when you definitely need to delay Medicare enrollment until you retire. That is if your employer’s coverage takes the form of a high-deductible health care plan paired with a health savings account (HSA). Under IRS rules you cannot contribute to an HSA in any month when you are enrolled in any part of Medicare (Part A, B or D).

For more information, see the following AARP articles: 

“Medicare When Working Beyond 65” at

“Can I Have a Health Savings Account as Well as Medicare?” at

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