65 and Still Working: Health Insurance Coverage Facts You Need to Know

65 and Still Working: Health Insurance Coverage Facts You Need to Know

Turning 65 years of age doesn’t automatically mean you’re going to retire. If you plan to continue working, you need to be aware of your health insurance options. When you turn 65, you become eligible for Medicare. Unless you are also receiving Social Security benefits, you are required to enroll in the Medicare program beginning three months before you are 65.

Health Insurance for Seniors – Medicare Overview

The four parts of Medicare are:

Part A – Hospital Insurance

This coverage is mainly for care in the hospital or at a skilled nursing facility as well as home health and hospice care services. It is free for those who have worked and paid Social Security taxes for at least 10 years; otherwise you must pay a monthly premium.

Part B – Medical Insurance

With Part B you are covered for most doctors’ visits, durable medical equipment, outpatient services, lab tests, x-rays, mental health care, home health and ambulance services. You must pay premiums for Part B coverage.

Part C – Medicare Advantage

Part C policies are offered by private insurers, as approved by Medicare. They put doctor visits, hospital care and outpatient care in a single plan. Prescription drug benefits are often included. Other coverage such as vision and dental can be added, but it will cost more.

Part D – Prescription Drug Insurance

This is provided through private insurance companies who are contracted by the government.

Enrollment Options

You have a few options pertaining to Medicare when you are 65 or older and still working.

If your employer (or your spouse’s) has fewer than 20 employees, the company can require you to enroll in Medicare. Consider enrolling in:

  • Medicare Part A and Part B and/or Medicare Part D; or
  • Medicare Part C, the Medicare Advantage Plan. If you choose a plan that doesn’t provide prescription drug coverage, you should also enroll in Part D.

If your employer has 20 or more employees, the company is required to offer current 65+ employees the same group health plan choices that are offered to other employees.

Most working people 65 or older enroll in Medicare Part A. If you remain on the employer’s health plan you can still:

  • Enroll in Part A and Part B as secondary payers, with the employer’s insurance being primary
  • Enroll in Part A but delay Part B an D

Keep in mind that if you choose to enroll in Part C (Medical Advantage), you may lose benefits through your employer’s insurance plan.

Additional Things to Be Aware Of

Medigap Plans

Many people opt to also purchase Medigap insurance, which is additional coverage offered by private insurance providers. It covers health care costs not covered by Medicare, such as co-payments, deductibles and health care when traveling outside the  U.S.

Affordable Care Act

Once you qualify for Medicare you are no longer eligible for coverage through the Affordable Care Act’s Health Insurance Marketplace.

Be sure to plan well ahead of your 65th birthday. Health insurance for seniors can seem confusing, and there are ramifications for making certain decisions, depending on your situation. Talk to an expert as well as your employer to learn as much as possible so you can make the best decisions for you.

Get more information about Medicare health insurance and explore your cost options here.


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