Can you delay Medicare Part A if you are still working?
Yes, you can delay Medicare Part A while still working, but whether you should depends on your Health Savings Account (HSA) contributions and whether your Part A is premium-free.
Key Rules for Delaying Part A
- Premium-Free Part A: If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), Part A is free. Most people choose to enroll in premium-free Part A at age 65 even while working because it costs nothing and can act as secondary insurance.
- When You Must Delay Part A (HSAs): If you contribute to a Health Savings Account (HSA), you must delay Part A. You cannot contribute to an HSA once you are enrolled in any part of Medicare. To avoid tax penalties, stop your HSA contributions at least 6 months before you plan to enroll in Medicare.
- Paying a Premium for Part A: If you have to pay a monthly premium for Part A (because you didn't work long enough to get it free), you can safely delay it without penalty as long as you have qualifying employer health coverage.
- Automatic Enrollment Warning: If you are already collecting Social Security benefits when you turn 65, you will be automatically enrolled in Medicare Part A (and Part B), and you cannot easily decline Part A without paying back your Social Security benefits.
Should I enroll in Medicare Part A while still working?
You should generally enroll in Medicare Part A at age 65 if it is premium-free, even if you are still working.
Review the following key rules to help you decide based on your specific situation:
When to Enroll in Part A While Working
- Premium-Free Part A: If you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters), Part A costs $0 per month. Signing up acts as secondary or supplemental coverage alongside your job-based health plan.
- Large Employers (20+ Employees): If your employer has 20 or more workers, your workplace insurance pays first (primary), and premium-free Part A pays second (secondary).
- Small Employers (Under 20 Employees): If your employer has fewer than 20 employees, Medicare typically becomes your primary insurance at age 65. You generally must enroll in both Part A and Part B right away to avoid coverage gaps.
When to Delay Part A
- You Must Pay a Premium: If you do not qualify for premium-free Part A (because you or your spouse lack 40 quarters of Medicare-covered work), you will have to pay a monthly premium. If you have good employer coverage, you can usually delay paying for Part A without a penalty until you stop working.
- You Contribute to a Health Savings Account (HSA): You cannot contribute to an HSA once you are enrolled in any part of Medicare, including Part A-only. If you want to keep making tax-free contributions to your HSA, you must delay Part A enrollment. Note that Part A coverage can retroactively apply for up to 6 months, so you should stop HSA contributions at least 6 months before you plan to apply for Medicare.
Is there a penalty for delaying Medicare Part A?
The Medicare Official Website states that the Medicare Part A late enrollment penalty adds a 10% increase to your monthly premium, which you must pay for twice the number of years you delayed signing up.
Who Does It Apply To?
- Most people get Medicare Part A for free because they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters).
- If you do not qualify for premium-free Part A, you must buy it and face a penalty if you fail to sign up during your Initial Enrollment Period (IEP).
- In 2026, the monthly Part A premium is $311 if you have 30–39 work credits, or $565 if you have fewer than 30 credits.
How the Penalty Works
- Extra Cost: Your monthly Part A premium goes up by 10%.
- Duration: You pay this higher price for twice the years you waited. For example, if you wait 2 years to enroll, you pay the penalty for 4 years.
- No Penalty with Creditable Coverage: You can delay enrollment without a penalty if you have other qualifying health coverage (like job-based insurance).
Is it mandatory to have Medicare Part A?
Medicare Part A is not universally mandatory, but it becomes automatically required if you are already collecting Social Security or Railroad Retirement Board (RRB) benefits.
When Part A is Automatic (Mandatory)
- Social Security Recipients: If you already receive Social Security or RRB benefits when you turn 65, you are automatically enrolled in Medicare Part A.
- No Opt-Out Without Penalty: Once you are enrolled and Part A is premium-free, you cannot voluntarily drop or terminate your coverage unless you also withdraw your Social Security application and repay all benefits received.
When Part A is Optional (Can Be Delayed)
- Still Working: If you are turning 65, still working, and covered by a creditable employer health plan, Part A is not mandatory.
- Delaying Social Security: If you have not yet claimed Social Security retirement benefits, you can choose to delay signing up for Part A.
- Contributing to an HSA: Many people who continue working past 65 choose to delay Part A so they can keep contributing pre-tax funds to a Health Savings Account (HSA), because you cannot contribute to an HSA once Medicare coverage starts.
- Paying a Premium: If you do not qualify for premium-free Part A (meaning you or your spouse didn't work and pay Medicare taxes for at least 10 years), enrollment is voluntary, though delaying it can lead to a late-enrollment penalty.
For official enrollment rules and guidelines, visit the Social Security Administration.
How to defer Medicare Part A?
You can defer Medicare Part A by simply not signing up during your Initial Enrollment Period if you are not collecting Social Security, but you must meet specific rules to avoid issues.
When You Can Defer Part A
- Active Employer Coverage: You can delay Part A without penalty if you or your spouse are actively working and covered by a group health plan from an employer with 20 or more employees.
- Not Receiving Social Security: If you have not started collecting Social Security benefits at age 65, your Part A enrollment is not automatic, allowing you to choose not to enroll yet.
When You Cannot Defer Part A (or Shouldn't)
- Automatic Enrollment: If you are already collecting Social Security benefits when you turn 65, you are automatically enrolled in Part A. To stop it, you must decline or return your Medicare card to the Social Security Administration.
- Health Savings Accounts (HSAs): If you want to keep contributing to an HSA, you must defer Part A and Part B. Enrolling in any part of Medicare stops HSA contributions.
- Small Employers or COBRA: If your employer has fewer than 20 employees, or if you rely on COBRA or retiree health plans, you cannot safely defer Part A without facing penalties or coverage gaps.
Should You Delay Medicare If You’re Still Working After 65? (Avoid Costly Mistakes)
9 related questions found
How much is Medicare Part B if you are still working?
If you are still working, Medicare Part B costs the same standard amount as it does for everyone else—$202.90 per month—unless your high income triggers a surcharge. However, depending on the size of your employer, you may not need to enroll in Part B or pay this premium yet.
Here is how your employment status and income affect your Medicare Part B costs and requirements:
1. Does Your Income Trigger a Surcharge?
Medicare uses your tax returns from two years prior to determine your rate. If you are working and earning a high salary, you may pay an Income-Related Monthly Adjustment Amount (IRMAA) surcharge on top of the standard premium:
- Standard Premium: $202.90/month if your individual income is $109,000 or less (or $218,000 or less for joint filers).
- High-Income Premium: Ranges from $284.10 to $689.90/month if your individual income exceeds $109,000 (or $218,000 for joint filers).
2. Can You Delay Part B to Avoid the Premium?
If you have health insurance through your current job (or your spouse’s current job), you can often delay enrolling in Part B to save on the monthly premium:
- If your employer has 20 or more employees: Your employer’s insurance is considered primary. You can safely delay Part B. When you eventually stop working or lose that coverage, you will get an 8-month Special Enrollment Period (SEP) to sign up for Part B without facing any late enrollment penalties.
- If your employer has fewer than 20 employees: Medicare typically becomes your primary insurance. You must enroll in Part B when you turn 65. If you don’t, your employer's plan might refuse to pay your medical bills, and you could face a permanent 10% late enrollment penalty for every year you delayed signing up.
Summary: What to Do Next
If your company has 20+ employees and you like your workplace coverage, you generally do not need to pay for Part B yet. To confirm your specific situation, check with your employer’s HR or benefits administrator before making a decision.
What is the biggest mistake seniors make when enrolling in Medicare?
The biggest mistake seniors make when enrolling in Medicare is missing key enrollment deadlines, which can lead to permanent, lifelong late-enrollment penalties and gaps in medical coverage.
Top Medicare Enrollment Mistakes
- Missing the Initial Enrollment Period (IEP): Your window to sign up is a 7-month period that starts 3 months before the month you turn 65, includes your birthday month, and ends 3 months after. Missing this window without qualifying for a special enrollment period leads to delays and penalties.
- Failing to Understand Work Rules: Many seniors either sign up for Part B when they don't need to (because they are still working and covered by an employer with 20 or more employees) or fail to realize they must sign up when they retire, missing their 8-month special window.
- Ignoring Prescription Drug Coverage (Part D): Failing to sign up for Part D when first eligible—even if you take no medications—can trigger a permanent 1% penalty added to your monthly premium for every month you delayed.
- Confusing Advantage and Supplement Plans: Assuming a low-premium Medicare Advantage plan always means lower overall out-of-pocket costs without checking network restrictions, copays, and prior authorization rules. You can read more details on avoiding these errors via the AARP Medicare Guide.
What are the disadvantages of delaying Medicare Part B?
Delaying Medicare Part B past your initial eligibility window can result in permanent lifetime financial penalties and restricted enrollment periods.
Lifetime Financial Penalties
- 10% Surcharge per Year: Your monthly premium increases by 10% for every full 12-month period you delayed enrollment without qualifying coverage.
- Permanent Cost Increase: You must pay this extra penalty amount every month for as long as you have Medicare Part B—it does not go away after a set number of years.
- Adjusts with Inflation: Because the penalty is a percentage rather than a flat fee, the dollar amount of the penalty rises whenever standard Part B base premiums increase.
Coverage and Enrollment Delays
- Limited Enrollment Windows: If you miss your Initial Enrollment Period, you cannot sign up anytime. You have to wait for the General Enrollment Period, which runs from January 1 to March 31 each year.
- Gap in Coverage Start Dates: Your actual medical coverage will not begin until July 1 of the year you finally enroll during the general period, leaving a potentially dangerous gap in medical protection.
Risk of Additional Penalties
- Part D Drug Penalty Trigger: Delaying medical coverage often aligns with missing prescription drug coverage, exposing you to an additional permanent Medicare Part D late enrollment penalty if you go 63 continuous days or more without creditable drug coverage.
- Ineligible Coverage Types: Relying on non-creditable plans—such as COBRA, individual marketplace insurance, or VA benefits alone—does not protect you from the Part B late penalty when you turn 65.
Can I pause Medicare Part B if I go back to work?
Yes, you can drop or pause Medicare Part B if you return to work and get health coverage from an employer with 20 or more employees.
Key Rules for Pausing Part B
- Large Employers (20+ employees): Your employer's group health plan pays primary, and Medicare pays secondary. You can drop Part B without a late penalty.
- Small Employers (Under 20 employees): Medicare is the primary payer. If you drop Part B here, you will face coverage gaps and lifetime late enrollment penalties.
Risks and Considerations
- Medigap Policies: If you drop Part B, you must also drop your Medigap (Medicare Supplement) policy. When you re-enroll in Medicare later, you may have to go through medical underwriting to get Medigap back, meaning you could be charged more or denied coverage based on pre-existing conditions (unless protected by state laws).
- Part A: If you are paying a premium for Part A, dropping Part B may require dropping Part A too. If Part A is premium-free, you generally keep it.
- Re-enrollment Later: When you stop working or lose your employer coverage, you get an 8-month Special Enrollment Period (SEP) to sign back up for Part B without penalties.
Read more about options during employment through UnitedHealthcare or review guidelines on Senior65.
What are the income limits for Medicare Part B premiums in 2026?
For 2026, the standard Medicare Part B monthly premium is $202.90, and higher-income beneficiaries pay an extra charge called IRMAA based on their 2024 modified adjusted gross income (MAGI).
2026 Part B Income Brackets and Total Premiums
If your income exceeds $109,000 for individual filers or $218,000 for joint filers, you will pay a higher monthly premium.
| Individual Return (2024 Income) | Married Filing Jointly (2024 Income) | Monthly Surcharge | Total Monthly Part B Premium |
|---|---|---|---|
| $109,000 or less | $218,000 or less | $0.00 | $202.90 |
| $109,001 – $137,000 | $218,001 – $274,000 | $81.20 | $284.10 |
| $137,001 – $171,000 | $274,001 – $342,000 | $202.90 | $405.80 |
| $171,001 – $205,000 | $342,001 – $410,000 | $324.60 | $527.50 |
| $205,001 – $499,999 | $410,001 – $749,999 | $446.30 | $649.20 |
| $500,000 and above | $750,000 and above | $487.00 | $689.90 |
Key Details to Remember
- Two-Year Lookback: Your 2026 premiums are determined using your tax return from 2024.
- Married Filing Separately: If you are married but file a separate tax return, the income threshold is $109,000 or less for the standard rate, but jumps to higher surcharge tiers much faster if your income is above that.
- Life-Changing Events: If your income dropped due to retirement, divorce, or the death of a spouse, you can appeal your IRMAA determination using Form SSA-44 via the Social Security Administration.