This depends on your situation. If you’ve worked at least ten years (40 quarters) under Medicare-covered employment and paid Medicare taxes during that time, you qualify for premium-free Medicare Part A and will be automatically enrolled at age 65 even if you’re still working. If your spouse has enough employment quarters, you can also qualify for premium-free Medicare Part A based on their work history.
Another Medicare eligibility requirement is that you need to be an American citizen or permanent legal resident of at least five straight years.
Suppose you don’t have enough work history to get Medicare Part A without paying a premium. In that case, you can decide to delay enrollment if you already have health coverage through an employer or union (or through your work or your spouse’s employer). Medicare Part B always comes with a monthly premium, so you may similarly choose to delay your Part B enrollment if you or your spouse are still working and have employer-based group coverage.
Remember, if you don’t sign up for Medicare when you’re first eligible and don’t have other coverage based on current employment, you could have to pay a late enrollment penalty later when you do enroll. The late-enrollment penalty applies to Medicare Part B (and Part A, if you have to pay a premium for it).
Decide if you want Medicare while you’re still working
One factor to consider is that even if you have health coverage through your employer or union, Medicare may help pay for some of the costs not covered by your group health plan. For example, enrolling in Medicare may be useful if you work for a small company (less than 20 employees) because Medicare could be the primary payer before your group health insurance. You may want to consult with your employer or union benefits administrator for specifics on how your health coverage and costs may compare with Medicare.
Suppose you decide to wait until your group coverage ends in enrolling in Medicare Part A and/or Part B. In that case, you’ll have an 8-month Special Enrollment Period to sign up for Medicare that starts once you stop working or your group coverage ends (whichever happens first). You can also enroll in Medicare at any time that you are still working and have employer-based coverage.
If you choose COBRA after you stop working, do not wait until your COBRA coverage ends to sign up for Medicare. Suppose you delay enrolling in Medicare Part A and/or Part B after your Special Enrollment Period ends. In that case, you’ll have to wait until the next General Enrollment Period (January 1 to March 31 every year) to enroll, and you may have to pay a late-enrollment penalty.