Who pays first decides it
| Your situation at 65 | Who pays first | Part B? |
|---|---|---|
| Group plan from your or your spouse's current job, employer has 20+ employees | Employer plan | You can usually delay it |
| Group plan from current job, employer has fewer than 20 employees | Medicare | Generally needed |
| Retiree coverage, COBRA or a Marketplace plan | Medicare | Needed; these don't count as current work |
If Medicare should pay first and you don't have Part B, your employer plan may pay little or nothing for care Part B would have covered. Ask your benefits office in writing how its plan works with Medicare.
What about Part A?
Most people get Part A without a premium, so many sign up at 65 even while working, and it can pay second after the employer plan for hospital stays. The exception is an HSA: you can't contribute once you have Part A. See HSAs and Medicare.
Signing up for Part B later
- Plan your date. Pick a Part B start date that matches the end of your employer coverage.
- Get the employer form. Your employer completes form CMS-L564, which shows you had group coverage from current work.
- Apply with Social Security. Send form CMS-40B with the CMS-L564 online at ssa.gov, by fax or mail, or at a local office.
- Choose your other coverage. You have 63 days after employer drug coverage ends to join Part D or a Medicare Advantage plan with drug coverage without a penalty.
Your Medigap open enrollment, when companies can't turn you down for health reasons, starts the month your Part B begins (OAR 836-052-0138). Delaying Part B while working also delays that window, which can be an advantage.
For Oregon workers
The same federal rules apply to private employers, state agencies, schools and local governments. Oregon public employers' retiree plans are different: PEBB and OEBB retiree medical coverage ends when you become eligible for Medicare. See working past 65 in Oregon, coverage through a spouse's employer and the Part B special enrollment period. To compare your employer plan with Medicare options, you can request a call from a licensed insurance agent.
Related questions
When should I sign up if I'm turning 65?
Your 7-month window.
What happens if I miss Medicare enrollment?
Late penalties explained.
How do I sign up for Medicare in Oregon?
The forms and where to send them.
Sources
- Medicare.gov — Working past 65
- Medicare.gov — Which insurance pays first
- Medicare.gov — Avoid late enrollment penalties
- Social Security — Sign up for Medicare
- OAR 836-052-0138 — Medicare supplement open enrollment (Oregon)
More questions in this guide
- Can I get Medicare before 65 if I'm on disability in Oregon?
- How do I sign up for Medicare in Oregon?
- What happens if I miss Medicare enrollment in Oregon?
- What happens to my Medicare plan if I move to Oregon?
- What happens to my Medicare if I move out of Oregon?
- When should I sign up for Medicare if I'm turning 65 in Oregon?
Part of the guide: Medicare enrollment periods in Oregon · All questions
Frequently asked questions
How long do I have to sign up after I stop working?
8 months, starting the month after your job or the group coverage ends, whichever comes first. Sign up before your employer coverage ends to avoid a gap. COBRA doesn't extend this window.
I have a health savings account. What should I do?
Once you have any part of Medicare, you can't contribute to an HSA. If you sign up after 65, Part A is usually backdated up to 6 months, so stop contributions 6 months before you enroll to avoid a tax penalty.
Do I need Part D if my employer plan covers drugs?
Not if that drug coverage is creditable, meaning it's expected to pay at least as much as Part D. Your employer must tell you each year. Keep that notice; it's your proof if you join Part D later.
Medicare in your Oregon county
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