A Question That More People Are Asking Than You Might Think
If you are turning 65 and still working, you are probably wondering whether you need to sign up for Medicare right now — and the honest answer is that it depends on your specific situation in ways that genuinely matter. This is one of the most common questions we hear at Walker Insure Advisors, and it is also one of the most misunderstood. Getting it right can save you from costly late enrollment penalties, protect your coverage without gaps, and make sure you are not paying for something you do not need yet. Getting it wrong, on the other hand, can follow you for years. So let’s walk through exactly what you need to know.
The Short Answer: It Depends on Where Your Health Insurance Is Coming From
The most important factor when you are turning 65 and still working is whether you have health insurance through your employer — and specifically, how many people that employer has on its payroll. That number changes everything about what Medicare requires you to do and when.
If you work for a company with 20 or more employees, your employer-sponsored health insurance is considered your primary coverage. That means Medicare does not have to be the first one to pay when you have a claim. In this situation, many working seniors in Las Vegas choose to delay Part B — the part that covers doctor visits and outpatient services — without facing a penalty, as long as they stay covered under that employer plan the entire time.
If your employer has fewer than 20 employees, the rules flip. Medicare becomes the primary payer, and your employer plan becomes secondary. In that case, delaying Medicare enrollment could leave you with serious coverage gaps, and skipping Part B could result in penalties that stick with you permanently once you do enroll.
What About Part A? Should You Sign Up at 65 Even If You Are Still Working?
For most people, enrolling in Medicare Part A at 65 makes sense even if you are still working — because Part A, which covers hospital stays, is premium-free for anyone who has worked and paid Medicare taxes for at least ten years. There is generally no reason to delay something that does not cost you anything.
The one exception worth knowing about is if you are contributing to a Health Savings Account, or HSA, through a high-deductible health plan at work. Once you enroll in any part of Medicare, you are no longer allowed to contribute to your HSA. If maximizing those contributions matters to your financial plan, that is a conversation worth having before you sign up for anything.
The Late Enrollment Penalty Is Real — And It Does Not Go Away
One of the things we make a point of explaining to every person who walks through our door here in Las Vegas is that Medicare late enrollment penalties are not a one-time fine. For Part B, the penalty adds ten percent to your monthly premium for every twelve-month period you went without coverage and were not eligible to delay. That penalty gets added to your premium for as long as you have Medicare. For Part D, the prescription drug coverage penalty works in a similar way.
This is why understanding your specific situation before your Initial Enrollment Period closes is so important. The window around your 65th birthday does not stay open long, and assumptions can be expensive.
What Nevada Seniors Who Are Still Working Should Do Right Now
The smartest first step is to sit down and look at the details of your current employer coverage — the size of your employer, what your plan actually costs you, and whether it truly qualifies as creditable coverage under Medicare’s rules. From there, the path forward becomes much clearer. You may decide to enroll in Part A only, delay everything, or go ahead and enroll in both parts. Each of those choices has consequences, and each one is right for someone — just not necessarily for everyone.
At Walker Insure Advisors, we believe every person in our community deserves a clear, honest answer — not a one-size-fits-all response that does not account for where you actually are in life. Jerome Walker and our team have helped Las Vegas seniors navigate exactly this kind of decision for over two decades, and we are here to help you do the same.
Let’s Talk Through Your Situation Together
If you are turning 65 and still working and you want to know exactly what you should do about Medicare right now, we would love to have that conversation with you. There is no pressure, no confusion, and no cost — just a straightforward talk about your options from people who genuinely care about getting it right. Visit us at walkerinsuranceadvisors.com or give us a call to schedule your free consultation today. One conversation can make a bigger difference than you might expect.
