How to apply for Medicare Part A only while still working?
You can sign up for premium-free Medicare Part A while still working by applying online through the Social Security Administration during your initial enrollment window or anytime after turning 65.
How to Sign Up Online
- Go to the Social Security Administration website.
- Choose the option to apply for Medicare Part A only.
- Avoid selecting the button for Part B if you plan to keep your job-based health insurance.
- Provide your Social Security number, birth location details, and employer group health plan dates.
Things to Keep in Mind
- HSA impact: Enrolling in Part A means you must stop making tax-free contributions to a Health Savings Account (HSA). Stop contributions at least six months before applying to avoid tax penalties.
- Part B choice: You can typically delay signing up for Part B and Part D without a penalty while covered by an active employer group health plan (with 20 or more employees).
- Alternative method: If you prefer phone support, call the Social Security Administration directly at 1-800-772-1213 and state that you want Part A only.
Can you have Medicare Part A and still work?
You can enroll in Medicare Part A while still working, and it is usually free if you or your spouse worked and paid Medicare taxes for at least 10 years.
Key Rules for Part A While Working
- Cost: Part A is premium-free for most eligible workers.
- Employer Size (20+ Employees): If your group health plan is from an employer with 20 or more workers, enrolling in Part A is optional. It can act as secondary insurance to help pay costs your work plan misses.
- Employer Size (Under 20 Employees): If your employer has fewer than 20 employees, Medicare usually becomes your primary insurance. You generally must sign up for both Part A and Part B.
- Health Savings Accounts (HSAs): You cannot contribute to an HSA once you enroll in any part of Medicare, including premium-free Part A. You must stop contributions at least six months before applying to avoid tax penalties.
Is there a penalty for not enrolling in Medicare Part A at age 65?
Yes, a late penalty applies if you do not qualify for premium-free Part A and delay enrollment.
How the Part A Penalty Works
- Extra Cost: Your monthly Part A premium increases by 10%.
- Duration: You pay this higher price for twice the number of years you delayed signing up.
- Example: Waiting two years to enroll means paying the 10% penalty for four years.
How to Avoid the Penalty
- Work History: Most people pay no Part A premium because they or their spouse worked and paid Medicare taxes for at least 10 years (40 quarters). Free Part A means no late penalty, regardless of when you sign up.
- Other Coverage: Delaying enrollment is safe without a penalty while covered by active group health insurance through a current job (for most employers with 20 or more employees).
How much will Medicare cost me if I am still working?
Your Medicare costs while working depend primarily on your work history, your current income, and your employer's size. If you or your spouse paid Medicare taxes for at least 10 years (40 quarters), Medicare Part A is $0 per month. However, Medicare Part B costs a standard baseline of $202.90 per month, which could be higher depending on your income.
1. The Cost Breakdown by Medicare Part
If you choose to enroll in Medicare while still employed, the primary costs include:
- Part A (Hospital Insurance): $0 per month for most people. If you do not have the 10-year tax history, it can cost up to $565 per month.
- Part B (Medical Insurance): The standard monthly premium is $202.90.
- Part D (Prescription Drugs): Premiums vary by private plan, averaging around $35 per month.
2. The High-Income Surcharge (IRMAA)
Because you are still working, your current earnings could trigger the Income-Related Monthly Adjustment Amount (IRMAA). Medicare uses your tax returns from two years prior to determine if you owe a surcharge. For example, if your modified adjusted gross income (MAGI) from two years ago was higher than $109,000 (individual) or $218,000 (joint), your Part B premium will scale upward from $284.00 to as high as $689.90 per month.
3. Your Employer's Size Dictates Your Strategy
You may not actually need to pay for Medicare Part B yet. Your next steps depend heavily on how many employees work at your company:
| Employer Size | Rules for Enrolling & Costs | Action Plan |
|---|---|---|
| 20+ Employees | Your employer plan remains primary. You can sign up for $0 Part A, but you can safely delay Part B to save on the $202.90+ monthly premium. You will not face late penalties as long as you maintain group coverage. | Enrolling in Part A is standard, but delay Part B and Part D unless your employer plan is exceptionally expensive or weak. |
| Fewer than 20 Employees | Medicare automatically becomes your primary insurer. Your employer plan becomes secondary and may refuse to pay until Medicare pays first. | You must enroll in Part A and Part B when you turn 65. Skipping Part B will cause severe coverage gaps and a permanent 10% late-enrollment penalty for every year you delayed. |
⚠️ Critical Warning for Health Savings Accounts (HSAs)
If you actively contribute to a Health Savings Account (HSA) through your job, enrolling in any part of Medicare (including the free Part A) completely prohibits you from making pre-tax contributions to your HSA. Doing so triggers immediate tax penalties from the IRS.
My primary recommendation: If you work for a large employer (20+ employees) and wish to keep building your HSA tax-free, delay enrolling in Medicare entirely until you officially retire or lose that employer coverage. When you eventually stop working, you will get an 8-month Special Enrollment Period to sign up for Medicare penalty-free.
How can I enroll in Medicare Part A only?
You can enroll in Medicare Part A only by submitting an online application through the Social Security Administration and declining Part B when prompted.
🗓 When to Enroll
- Initial Period: Starts 3 months before your 65th birthday.
- Duration: Lasts for a total of 7 months.
- Working Past 65: You can sign up anytime while covered by an employer plan.
💻 Online Application Steps
- Visit Site: Go to the Social Security Medicare Portal.
- Sign In: Log into your my Social Security Account.
- Select Medicare: Choose to apply for Medicare only, not cash benefits.
- Decline Part B: Select "No" when asked if you want to enroll in Part B.
- Submit: Review your details and submit the application.
📞 Alternative Methods
- By Phone: Call Social Security at 1-800-772-1213.
- In Person: Visit your local Social Security office.
- Railroad Workers: Contact the Railroad Retirement Board instead.
Working past 65? Avoid these HUGE Medicare mistakes.
How to apply for Medicare Part A while still working?
You can apply online through the Social Security Administration to sign up for Medicare Part A while you are still working.
How to Sign Up
- Go to the Social Security Administration website to complete your application online.
- Choose the option to apply for Part A only if you want to delay Part B and keep your employer coverage.
- You can sign up during your Initial Enrollment Period, which begins 3 months before the month you turn 65 and ends 3 months after that month.
What to Consider
- Cost: Part A is usually premium-free if you or your spouse worked and paid Medicare taxes for at least 10 years (40 quarters).
- Health Savings Accounts (HSAs): You must stop making contributions to your HSA at least 6 months before you enroll in Part A to avoid tax penalties.
- Employer Size: If your employer has fewer than 20 employees, you generally need to sign up for both Part A and Part B when you turn 65 because Medicare acts as your primary insurance. If your employer has 20 or more employees, your group plan is primary, and Part A acts as secondary insurance.
Is Medicare Part A free at age 65 for seniors?
Medicare Part A is free (has a $0 monthly premium) for most seniors aged 65 and older.
Who Gets Free Part A?
You do not pay a monthly premium for Part A if you or your spouse worked and paid Medicare taxes for at least 10 years (40 work quarters). About 99% of people qualify for this premium-free coverage.
Who Has to Pay for Part A?
If you do not have enough work credits, you can still buy Part A, but you will pay a monthly fee:
- 30 to 39 work quarters: $311 per month
- Fewer than 30 work quarters: $565 per month
Other Part A Costs
Even with a $0 monthly premium, Part A is not completely free when you use care. You still have out-of-pocket costs:
- Hospital deductible: $1,736 per benefit period (in 2026)
- Daily coinsurance: $0 for the first 60 days, but it increases for longer hospital stays or skilled nursing care.
You can review official details through the Fact Sheet on 2026 Medicare Costs.
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 happens if I decline Medicare Part B when I turn 65?
Declining Medicare Part B at age 65 means you will not have medical insurance for doctor visits or outpatient care, and you may face a permanent late-enrollment penalty unless you have qualifying active employer coverage.
💡 What Happens Based on Your Coverage
- ✅ With Active Employer Coverage:
- No penalty if your employer has 20+ employees.
- You get an 8-month window to sign up later without penalties when you retire.
- ⚠️ Without Qualifying Coverage (Uninsured, Marketplace, COBRA):
- You get a permanent 10% premium penalty for each full year you delay.
- You must pay this higher monthly cost for as long as you have Part B.
- You have to wait for the General Enrollment Period (January 1–March 31) to sign up, leaving gaps in care.
📊 Penalty Breakdown Example
Assuming a standard monthly Part B baseline cost of around $185:
- 1-Year Delay: Extra $18.50 added to your monthly bill for life.
- 3-Year Delay: Extra $55.50 added to your monthly bill for life.
🗒 How to Decline Part B Correctly
- If automated (taking Social Security): Wait for your red, white, and blue Medicare card, then follow the instructions on the back to sign and return it declining Part B.
- If manual (not taking Social Security): Simply choose to enroll in Part A only and decline Part B during your online application via the Social Security Administration.
Is Medicare Part D really necessary?
Medicare Part D is optional, but skipping it is risky unless you have other qualifying prescription coverage.
When You Might Not Need It
You do not need a standalone Part D plan if you already have creditable prescription drug coverage, meaning coverage that is expected to pay at least as much as standard Medicare prescription coverage. This includes:
- An employer or union health plan (from your own or a spouse's current work)
- Veterans Affairs (VA) benefits
- Tricare (military coverage)
- Federal Employee Health Benefits (FEHB)
- A Medicare Advantage plan (Part C) that already includes prescription drug coverage
Why You Should Still Consider It
If you do not have one of the alternative coverages listed above, going without Part D creates major financial risks:
- Late Enrollment Penalties: If you go 63 days or more without Part D or creditable coverage after becoming eligible, you face a permanent late penalty. This adds 1% to the national base premium for every uncovered month, and you pay it forever.
- High Out-of-Pocket Costs: Original Medicare (Parts A and B) does not cover outpatient prescription drugs. Without insurance, you pay full retail price for medications.
- Financial Protections: Modern Part D plans feature helpful caps, such as a $35 monthly cap on insulin and a strict out-of-pocket spending limit on covered drugs.
You can review available options or check plan details directly through Medicare.gov.