Medicare and Employer Coverage in Utah

Do I have to enroll in Medicare if I have coverage through work?  This is one of the most common questions I get when it comes to someone that is turning 65 and still working.  Usually, the answer is no, you don’t have to go onto Medicare if you have employer coverage, but let’s break it down.

Why you MAY NOT need Medicare right now:

1. Your employer plan already covers you and your spouse

If your employer insurance is good and you are not paying an arm and leg, you probably don’t want Medicare now.

2. Medicare lets you delay without penalty

As long as you have employer coverage and the plan has 20+ employees on the plan, you can delay Medicare for as long as you want to stay on that plan and you will not have penalties later.

3. You don’t need to pay for both

Part B has a monthly premium ($202.90 for most people in 2026), so many people wait on part B to avoid paying extra.  You can enroll in part A of Medicare and continue with your employer insurance if you want because it is free as long as you have worked for 10 years.  Just don’t enroll in any part of Medicare if you want to continue to contribute to an HSA.

4. You can enroll later when you retire

When you retire or lose coverage, you get a special enrollment period with no penalty to go onto Medicare and pick whatever plan you want.

Why you MAY need Medicare even if working

1. If your employer has fewer than 20 employees

Medicare usually becomes your primary insurance if your plan has less than 20 employees on it.  So it usually doesn’t make sense to pay for an employer plan that is secondary to Medicare.

2. Your employer plan might require Medicare

Some employer plans expect you to enroll in Part B at 65.

3. Medicare could lower your overall costs

Sometimes Medicare is cheaper than staying on employer coverage.

4. You want extra coverage

Medicare can help cover costs your employer plan doesn’t.

Here is an easy way to remember it.  If your employer coverage is good and your company has 20 or more employees, you can delay Medicare without penalty. When you retire, you’ll get a special enrollment period to enroll.

Do a quick analysis.  I always recommend doing a quick employer coverage vs medicare analysis to make sure you are not leaving money on the table.  Some employer plans are very expensive and in a lot of cases, you can get better coverage for less premium with Medicare.  Sometimes the opposite is true and you can save money with your employer plan.  If you need help, we would love to help you do a plan comparison for you to see whether it makes sense to stay on your employer plan, or go onto Medicare.