Do You Have To Be Retired To Get Medicare

You do not have to be retired to get Medicare

Medicare is available to people who are not retired at all. You can be working full-time, part-time, or self-employed and still get Medicare if you meet one of the pathways into the program. The most common path is age — you become may be able to access at 65 regardless of whether you work. But you can also get Medicare before 65 if you have been receiving Social Security Disability Insurance (SSDI) for 24 months, if you have end-stage renal disease (ESRD), or if you have amyotrophic lateral sclerosis (ALS). Working does not stop any of these pathways from opening.

The confusion often comes from the word "retirement" itself. Medicare and retirement are separate decisions. You can retire and not yet be on Medicare (if you are under 65 and do not have SSDI, ESRD, or ALS). You can also be on Medicare and still working. Some people work past 65 specifically because they want to stay on their employer's health plan instead of switching to Medicare, and that is a choice you can make — but it is a choice, not a requirement.

Key Takeaways

You become may be able to access for Medicare at 65 whether you are retired or still working.
You can get Medicare before 65 if you have received SSDI for 24 months, have end-stage renal disease, or have ALS.
Working does not disqualify you from Medicare or change when you become may be able to access.
If you are still employed at 65, you can choose to stay on your employer's health plan or switch to Medicare.

Getting Medicare at 65 while still working

When you turn 65, you enter your Initial Enrollment Period (IEP), which runs for three months before your birthday month, during your birthday month, and for three months after. During this window, you can sign up for Medicare Part A (hospital insurance) and Part B (medical insurance) without penalty, even if you are still working and covered by an employer plan.

If you are covered by an employer health plan through your own job (not a spouse's), you have the option to delay Part B without penalty as long as you remain employed. This is called the special enrollment period for group health plan coverage. You can stay on your employer plan and sign up for Part B later without the 10% monthly penalty that normally applies to late enrollment. You must sign up within eight months of leaving that job or losing the coverage, or the penalty will explore.

Part A (hospital insurance) works differently. If you are 65 and may be able to access, you should sign up for Part A even if you stay on your employer plan, because Part A has no monthly premium for most people and covers hospital stays. Delaying Part A can result in a permanent penalty if you wait too long after leaving employment.

Getting Medicare before 65 through disability

If you have been receiving SSDI for 24 consecutive months, you become may be able to access for Medicare at that point, regardless of your age or work status. You do not have to stop working to get this Medicare coverage. The 24-month waiting period starts from the month you first received an SSDI payment, not from the month you applied.

People with end-stage renal disease (ESRD) — permanent kidney failure requiring dialysis or transplant — can get Medicare when ready upon diagnosis, even if they are young and working. Similarly, anyone diagnosed with ALS (Lou Gehrig's disease) becomes may be able to access for Medicare right away, with no waiting period.

In all three cases, you will be automatically enrolled in Medicare Part A and Part B once you meet the condition. You will receive a Medicare card in the mail. If you are working and have employer coverage, Medicare becomes your secondary payer, meaning your employer plan pays first for covered services, and Medicare covers what remains.

What happens to your employer health plan when you get Medicare

Getting Medicare does not automatically end your employer health plan. You can keep both. However, the coordination between them changes. Once you are on Medicare, your employer plan becomes the secondary payer for most services, which means Medicare pays first. Some employers require you to drop their plan once you are on Medicare, so check your plan documents or call your benefits administrator to understand your specific situation.

If you are still working and your employer has 20 or more employees, Medicare will not pay for services that your employer plan should cover. Your employer plan pays first, and Medicare pays second. This is called coordination of benefits. If your employer has fewer than 20 employees, Medicare pays first.

Continuing to work while on Medicare

There is no earnings limit or work requirement tied to Medicare itself. You can work as much as you want without affecting your Medicare coverage. However, if you are under 67 and receiving Social Security retirement benefits (not SSDI), your benefits will be reduced by $1 for every $2 you earn above the annual earnings limit — but this does not affect Medicare. The earnings limit changes each year; you can check the current amount on the Social Security Administration website.

If you are self-employed and on Medicare, you still pay the self-employment tax, which funds Social Security and Medicare. Being on Medicare does not change your tax obligations.

When you must sign up for Medicare

Your Initial Enrollment Period is the safest time to sign up, but the rules differ depending on your situation. If you are 65 and not covered by an employer plan through your own job, you should sign up during your IEP to avoid penalties. If you are covered by an employer plan through your job, you have until eight months after you leave that job or lose the coverage to sign up for Part B without penalty.

If you miss your IEP and do not may have access to for a special enrollment period, you can sign up during the General Enrollment Period, which runs January 1 through March 31 each year. However, a late enrollment penalty will be added to your Part B premium for as long as you have Medicare. The penalty is 10% of the Part B premium for each full 12-month period you were may be able to access but not enrolled.

How to sign up for Medicare while working

You can sign up for Medicare online at Medicare.gov, by phone at 1-800-MEDICARE (1-800-633-4227), or in person at your local Social Security office. You will need your Social Security number, birth certificate, proof of citizenship or legal residency, and proof of income (such as a recent tax return or pay stub).

If you are still working and want to delay Part B, you will need to submit a form stating that you are declining Part B coverage. This protects you from the late enrollment penalty later. The form is called the CMS-L564, and you can submit it when you sign up for Part A, or later when you are ready to enroll in Part B.

Questions to ask your doctor and employer

Before you turn 65 or become may be able to access for Medicare, talk to your employer's benefits administrator about how Medicare will coordinate with your current health plan. Ask whether your employer requires you to drop their plan once you are on Medicare, and whether there are any important date you need to know about. If you are considering delaying Part B, ask your doctor whether there are any services you use regularly that might not be covered as well under Medicare as they are under your current plan.

If you have questions about your specific situation — for example, if you are self-employed or have an unusual work arrangement — call Medicare at 1-800-MEDICARE and ask to speak with someone who can review your circumstances. They can tell you exactly when you need to sign up and what penalties, if any, might explore.

Frequently Asked Questions

Can I work and be on Medicare at the same time?

Yes. Working does not disqualify you from Medicare or change your coverage. You can work full-time, part-time, or be self-employed and have Medicare. If you are under 67 and receiving Social Security retirement benefits, your benefits may be reduced based on earnings, but your Medicare coverage continues.

What if I am 65 but still covered by my employer's health plan?

You can stay on your employer plan and delay Part B without penalty as long as you remain employed and covered through your job. You should still sign up for Part A during your Initial Enrollment Period, since Part A usually has no premium. When you leave the job or lose coverage, you have eight months to sign up for Part B.

Do I lose Medicare if I go back to work after retiring?

No. Once you are on Medicare, going back to work does not affect your coverage. You keep Medicare regardless of your employment status or income.

What if I am on disability but still working?

If you have been receiving SSDI for 24 months, you become may be able to access for Medicare even if you continue working. Some people on SSDI work part-time or in jobs that pay below a certain threshold. Your work does not change your Medicare may be able to access.

Will Medicare be my primary or secondary insurance if I am still working?

If your employer has 20 or more employees, your employer plan is primary and Medicare is secondary. If your employer has fewer than 20 employees, Medicare is primary. Your employer's benefits administrator can tell you which applies to you.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.