Still Working After 65? Here’s What You Need to Know About Medicare

Turning 65 doesn’t automatically mean you have to enroll in every part of Medicare.

In fact, if you’re still working or covered under your spouse’s employer health insurance, your Medicare decision may be very different from someone who has already retired.

One of the biggest misconceptions I hear is, “Everyone has to sign up for Medicare at 65.” The truth is, that’s simply not the case. Enrolling too early—or waiting too long—can both create costly mistakes if you don’t understand how your current health insurance works with Medicare.

Let’s break it down.

There Are Three Common Medicare Paths

If you’re approaching age 65 and still working, you’ll generally fall into one of these situations:

1. Delay Medicare because you have qualifying employer coverage.

If you or your spouse are actively working and covered by a qualifying employer health plan, you may be able to postpone certain parts of Medicare without facing late enrollment penalties.

2. Enroll in Medicare Part A only.

Many people qualify for premium-free Medicare Part A. Depending on your situation, enrolling in Part A while delaying Part B may make sense—but not for everyone.

3. Enroll in both Part A and Part B.

If your current coverage doesn’t allow you to delay Medicare, enrolling on time is important to avoid lifelong penalties and unexpected gaps in coverage.

The right choice depends on your individual situation—not what your neighbor, friend, or coworker decided to do.

Active Employer Coverage Makes a Difference

One of the most important questions is whether your health insurance is based on current active employment.

If you’re actively working—or covered under your spouse’s active employer plan—you may qualify for a Special Enrollment Period later when you retire.

However, Medicare treats these types of coverage very differently:

• Active employer coverage
• COBRA
• Retiree insurance
• Marketplace (ACA) plans

Although they may seem similar, Medicare rules are completely different for each one.

Employer Size Matters

 

Another factor many people don’t realize is the size of your employer.

Generally speaking:

• Employers with 20 or more employees usually remain your primary insurance while you’re actively working.
• Employers with fewer than 20 employees often require Medicare to become your primary coverage at age 65.

If Medicare should be primary and you don’t enroll, you could end up responsible for medical bills your employer plan doesn’t pay.

That’s why it’s so important to verify your specific situation before making a decision.

Be Careful If You Have a Health Savings Account (HSA)

One of the most common mistakes people make is enrolling in Medicare Part A because they’ve heard it’s “free.”

While Part A usually doesn’t have a monthly premium, enrolling in any part of Medicare generally means you can no longer contribute to a Health Savings Account (HSA).

Many people don’t realize that Medicare Part A can even be retroactive for several months when you enroll after age 65. That retroactive coverage can create tax issues if HSA contributions continued during that period.

If you’re contributing to an HSA, it’s worth discussing your options before enrolling in Medicare.

What About Medicare Part B?

Medicare Part B covers services like:

• Doctor visits
• Outpatient care
• Lab work
• Preventive services
• Medical equipment

Unlike Part A, Part B has a monthly premium.

If you’re eligible to delay Part B because you have qualifying employer coverage, paying that premium early may not be necessary.

However, delaying Part B when you don’t qualify can result in a permanent late enrollment penalty that stays with you for as long as you have Medicare.

Don’t Forget Prescription Drug Coverage

Even if your medical insurance allows you to delay Medicare, your prescription drug coverage must also meet Medicare’s standards.

This is known as creditable prescription drug coverage.

If your employer’s drug plan isn’t considered creditable and you wait too long to enroll in Medicare Part D, you could face a lifelong late enrollment penalty.

Always ask your employer for written confirmation that your prescription drug coverage is considered creditable.

What Happens When You Retire?

Once your employer coverage ends, you don’t automatically move into Medicare.

You’ll need to enroll during your Special Enrollment Period.

Planning ahead is extremely important because different parts of Medicare have different enrollment timelines.

Starting the process a few months before retirement helps ensure your coverage begins when you need it without unnecessary delays.

Think About Your Spouse

Your Medicare decision may affect your spouse or other dependents who are covered under your employer’s insurance.

Before leaving your employer plan, find out:

• Can your spouse remain on the employer plan?
• Will they need COBRA?
• Should they purchase other health insurance?
• What will their monthly costs be?

These answers can significantly impact your retirement planning.

Five Questions to Ask Yourself

Before deciding whether to enroll in Medicare, ask yourself:

• Am I covered by active employer insurance?
• Is my spouse’s employer providing my coverage?
• Does the employer have at least 20 employees?
• Am I contributing to a Health Savings Account?
• Is my prescription drug coverage considered creditable?

Answering these questions can help you avoid costly mistakes and unnecessary penalties.

The Bottom Line

There isn’t a one-size-fits-all Medicare decision for people who continue working after age 65.

Your employer coverage, your spouse’s insurance, your HSA contributions, prescription drug coverage, and retirement plans all play an important role.

The good news is you don’t have to figure it out alone.

At Life and Med – Medicare Resource Center, we take the time to review your unique situation and explain your options clearly, so you can make an informed decision with confidence.

If you’re approaching age 65 or planning to retire soon, let’s talk before you enroll. A short conversation today could help you avoid expensive mistakes tomorrow.

 Office: 216 N 3rd St, Suite B, Leesburg, FL
 Phone: 352-260-0202

Helping individuals throughout Central Florida navigate Medicare with confidence.

Your Medicare plan worked for you last year—but is it still working for you in 2027?

Fall is here, which means it’s time for something important: the Medicare Annual Election Period!

From October 15 through December 7, Medicare beneficiaries have an opportunity to review and change their Medicare Advantage or Part D coverage for the upcoming year. Any changes made during this period generally take effect January 1, 2027.

At Life and Med: Medicare Resource Center, we know Medicare can feel like a lot to keep up with. Plans change. Doctors change networks. Prescription coverage changes. And those plan notices that arrive in the mail? They aren’t exactly beach reading!

That’s where we come in.

🔎 First Question: Did Your Plan Change?

Every year, Medicare Advantage and Part D plans can make changes to things like:

• Premiums
• Benefits
• Provider networks
• Prescription drug coverage
• Formularies

Those changes can affect whether your current plan is still the best fit for you.

Just because your plan worked well last year doesn’t automatically mean it’s the right choice for next year.

📬 Don’t Ignore Any Mail From Your Health Insurance Carrier!

Your Annual Notice of Change (ANOC) is one of the most important pieces of mail you’ll receive during this time of year.

Plans send these notices by September 30, and they explain what’s changing for the upcoming year.

So before you toss that envelope into the “I’ll look at it later” pile, take a look!

💊 Check Your Prescriptions

Have your medications changed?

Even one new prescription can make a difference when you’re comparing Part D plans. Make a current list of your medications, including the dosage and how often you take them, so you can properly review your drug coverage.

👩‍⚕️ Are Your Doctors Still in Your Network?

Your doctors matter!

If you have Medicare Advantage, check that your favorite doctors, specialists, hospitals, and other providers are still participating in your plan for 2027. Provider networks can change from year to year.

Because the last thing you want is to discover a change after you need care.

💰 Don’t Look at Just One Number

When reviewing your Medicare options, don’t focus only on the monthly premium.

Consider the whole picture:

Premium + prescriptions + doctors + benefits + out-of-pocket costs = the bigger picture.

A plan with a low premium isn’t necessarily the best fit if it doesn’t cover the doctors or medications you need.

📅 Put These Dates on Your Calendar

October 15 – December 7, 2026

That’s your Medicare Annual Election Period.

You can use this time to review and, if appropriate, change your Medicare Advantage or Part D plan for 2027.

And remember: you don’t have to change your plan just because AEP arrives.

If you’re happy with your current Medicare Advantage or Part D coverage, you may be able to keep it. But it’s still smart to review your Annual Notice of Change to make sure you understand what’s changing.

🧠 Medicare Doesn’t Have to Be a Guessing Game

You don’t have to spend hours comparing plans, trying to understand insurance terminology, or wondering whether you’re missing something important.

That’s what we’re here for.

At Life and Med: Medicare Resource Center, we help make Medicare easier to understand so you can make an informed decision about your coverage.

❤️ Have Medicare Questions? We’re Here to Help!

Life and Med: Medicare Resource Center
📍 216 N 3rd St, Suite B, Leesburg, FL 34748
📞 352-260-0202

Local Medicare help from a local Medicare resource center—not a call center.

How to Read Your Medicare Summary Notice (MSN): A Simple Guide for Medicare Beneficiaries

If you receive a Medicare Summary Notice (MSN) in the mail and wonder, “Is this a bill? Do I owe money?” — you are not alone. Many Medicare beneficiaries find these statements confusing at first.

The good news? Your Medicare Summary Notice is actually a helpful tool that allows you to understand how Medicare processed your healthcare claims, what Medicare paid, and what steps you may need to take if something does not look right.

Let’s break it down.

First: Your Medicare Summary Notice Is NOT a Bill

One of the most important things to remember is that your Medicare Summary Notice is not a bill.

It is a statement from Medicare showing:

• The medical services or supplies billed to Medicare
• Whether Medicare approved or denied the claim
• How much Medicare paid
• The amount you may owe if you do not have additional insurance coverage

The amount listed as “you may owe” is not always your final responsibility. If you have a Medicare Supplement (Medigap) plan, employer retiree coverage, Medicaid, or another secondary insurance plan, those policies may pay some or all of the remaining costs.

Always check your other insurance Explanation of Benefits (EOB) statements to understand your actual out-of-pocket expenses.

What Information Is Included on Your MSN?

Your Medicare Summary Notice covers a specific time period and provides details about healthcare services Medicare processed.

For each claim, you can review:

• The date you received care
• The provider who submitted the claim
• The service or item billed
• What Medicare approved
• What Medicare paid
• Any remaining amount that may apply to you

Reviewing your MSN regularly can help you catch billing mistakes and better understand your healthcare costs.

Understanding Your Medicare Deductible

Your MSN also helps you track your deductible status.

For example, your notice may show how much of your Medicare Part B deductible has been met. Medicare applies deductible amounts based on when claims are processed — not necessarily the date you received the service.

This means you may receive a bill weeks or months after your appointment because Medicare processed the claim later.

Remember:

Meeting your deductible and paying your deductible are two different things.

Medicare tracks what applies toward your deductible, but your provider is the one who bills you for your responsibility.

Don’t Skip the “Notes for Claims Above” Section

One of the most useful sections of your Medicare Summary Notice is often the one people overlook: “Notes for Claims Above.”

Each claim may have a letter beside it that connects to an explanation at the bottom of the page.

These notes can tell you:

• Why Medicare approved or denied a claim
• Whether an amount was applied toward your deductible
• Additional information about Medicare coverage rules

If you do not understand one of the notes, do not ignore it. Asking questions early can prevent confusion later.

What Should You Do If Medicare Denies a Claim?

Seeing the word “denied” on your MSN can be concerning, but it does not always mean you are responsible for the bill.

Start by contacting your healthcare provider.

Ask:

• Did they receive the denial?
• Was there a billing or coding error?
• Will they correct and resubmit the claim?

Many claim issues are resolved between Medicare and the provider without requiring further action from you.

If you receive a bill, request an itemized statement so you understand exactly what you are being charged for.

You Have the Right to Appeal

If a claim denial is not corrected and you believe Medicare made the wrong decision, you have the right to appeal.

Your Medicare Summary Notice includes instructions for filing an appeal.

In many situations, Medicare appeals must be filed within 120 days from the date on your MSN, so do not wait too long if you believe something needs to be reviewed.

Check Your MSN for Errors and Fraud

Reviewing your Medicare Summary Notice is also an important way to protect yourself from Medicare fraud.

Look carefully for:

• Providers you do not recognize
• Services you did not receive
• Incorrect dates of service
• Charges that seem unusual

If something does not look right, contact Medicare and report the concern.

Your Medicare benefits are valuable. Staying informed helps protect both you and the Medicare system.

Paper MSN vs. Electronic MSN

Beginning in 2026, Medicare will mail paper Medicare Summary Notices less frequently. Beneficiaries who want quicker access can choose electronic MSNs through their Medicare account.

Electronic notices can make it easier to:

• Review claims sooner
• Keep records organized
• Track healthcare expenses throughout the year

Your Medicare Summary Notice Is a Tool — Use It

Your Medicare Summary Notice is more than paperwork. It is a way to stay informed about your healthcare coverage.

By reviewing your MSN, you can:

✔ Understand how Medicare paid your claims
✔ Catch billing mistakes
✔ Monitor your healthcare expenses
✔ Help protect yourself from fraud

Medicare can feel complicated, but you do not have to navigate it alone.

At Life and Med – Medicare Resource Center, we help Medicare beneficiaries understand their options and make informed decisions about their coverage.

Have questions about Medicare? Get local, personalized help.

We’re here to help you make informed decisions and get the most from your Medicare benefits.

 Office: 216 N 3rd St, Suite B, Leesburg, FL
 Phone: 352-260-0202

Moving to another state can be an exciting new chapter—whether you’re relocating to be closer to family, moving for retirement, or simply looking for a change of scenery.

But if you’re enrolled in Medicare, you may have an important question:

“Will my Medicare coverage follow me when I move?”

The answer depends on the type of Medicare coverage you have.

At Life and Med: Medicare Resource Center, we help Medicare beneficiaries understand what can happen to their coverage when they move. If you’re relocating to Florida—or moving from Florida to another state—understanding your options before you move can help make the transition much smoother.

🇺🇸 What Happens to Original Medicare When You Move?

The good news is that Original Medicare travels with you throughout the United States.

Original Medicare includes:

• Medicare Part A – generally covers inpatient hospital care and certain other services.
• Medicare Part B – generally covers doctor visits, outpatient care, preventive services, and medically necessary services.

Because Original Medicare is a federal program, your Part A and Part B benefits generally don’t change simply because you move from one state to another.

However, you may need to find new doctors, hospitals, specialists, pharmacies, and other healthcare providers in your new area.

Before your move, it’s a good idea to research healthcare providers who accept Medicare in your new community.

🏥 What If I Have a Medicare Advantage Plan?

This is where moving can make a much bigger difference.

Medicare Advantage plans are offered by private insurance companies and generally have specific service areas and provider networks.

Your current Medicare Advantage plan may not be available where you’re moving.

For example, if you have a Medicare Advantage plan in another state and move permanently to Florida, your current plan may not operate in your new Florida ZIP code.

If your move takes you outside your plan’s service area, you generally qualify for a Special Enrollment Period (SEP) that allows you to choose a new Medicare Advantage plan available in your new location or return to Original Medicare.

Before you move, consider these steps:

1. Contact your Medicare Advantage plan.
2. Let them know you’re moving and provide your new address.
3. Ask whether your current plan is available at your new address.
4. Find out how your coverage will work during the transition.
5. Research Medicare Advantage plans available in your new area.
6. Check whether your preferred doctors and prescriptions will be covered.

Don’t wait until after the moving truck arrives to start looking into your Medicare coverage.

💊 What Happens to Medicare Part D When I Move?

If you have a stand-alone Medicare Part D prescription drug plan, moving can also affect your coverage.

Part D plans are offered by private insurance companies and can vary depending on where you live.

Your current prescription drug plan may not be offered in your new location.

If you move outside your plan’s service area, you generally qualify for a Special Enrollment Period to select a new Part D plan available in your new area.

Before moving, make a list of:

• All your current medications
• Your preferred pharmacy
• Your prescription costs
• Any medications that require prior authorization
• Your current Part D plan

Then compare your options after you know your new ZIP code.

A plan that worked well at your old address may not necessarily be the best fit at your new one.

🩺 What About Medicare Supplement Plans?

Medicare Supplement insurance, also known as Medigap, works differently from Medicare Advantage.

If you have a Medigap policy and continue to have Original Medicare, you can generally keep your Medigap policy when you move to another state.

Your Medigap benefits generally don’t change simply because you move.

However, if you decide to purchase a different Medigap policy after moving, your options and costs may be different depending on your circumstances and the rules in your new state.

This is one reason it’s important to talk with a licensed Medicare professional before dropping or changing a Medigap policy.

Don’t cancel your existing coverage until you understand what your new options are.

⏰ How Long Do I Have to Change My Medicare Advantage or Part D Plan?

Moving can trigger a Special Enrollment Period, but the timing depends on your circumstances.

Generally, if you move outside your current Medicare Advantage or Part D plan’s service area, you can make changes around the time of your move.

In many situations, you can notify your plan before moving and make a change during the month before your move and for two months afterward.

If you wait until after you move to notify your plan, your Special Enrollment Period may begin when you notify the plan.

Because individual circumstances can vary, it’s important to verify your specific enrollment window with Medicare or your plan.

Don’t wait until the last minute.

Moving involves enough paperwork already.

Getting your Medicare coverage organized ahead of time can help prevent unnecessary gaps or confusion.

🗺️ What If You Split Your Time Between Two States?

Some retirees spend part of the year in Florida and part of the year somewhere else.

If you regularly live in two states, Medicare coverage can become a little more complicated.

With Original Medicare, you generally have greater flexibility to receive care throughout the United States from providers who accept Medicare.

Medicare Advantage plans, however, typically have service areas and provider networks that you need to understand—especially if you spend several months outside your plan’s service area.

If you’re a seasonal resident, review your plan’s rules carefully before deciding which type of coverage works best for your situation.

📬 Don’t Forget to Update Your Address

When you move, make sure your address is updated with the appropriate government agencies and your insurance company.

Keeping your information current helps ensure that you receive important Medicare and plan-related notices.

You should also update your address with:

• Social Security
• Your Medicare Advantage or Part D plan
• Your healthcare providers
• Your pharmacy
• Other insurance companies you have coverage through

You don’t want important Medicare paperwork showing up at your old address!

🧳 Moving to Florida? We’re Here to Help.

Florida is a popular destination for retirees and families relocating to be closer to loved ones.

If you’re moving to Leesburg or the surrounding Central Florida area, your Medicare options may be different from the coverage available where you currently live.

Your ZIP code, doctors, prescriptions, and healthcare needs can all affect which plans are available to you.

That’s where having a local Medicare resource can be helpful.

At Life and Med: Medicare Resource Center, we help Medicare beneficiaries understand their options when they’re moving, turning 65, reviewing their coverage, or simply trying to make sense of Medicare.

💪 We’re Not Playing Around When It Comes to Medicare!

Moving is stressful enough without having to figure out Medicare at the same time.

Whether you’re moving across town, across Florida, or across the country, don’t assume your Medicare coverage will automatically work the same way at your new address.

Check your coverage before you move.

Understanding your options ahead of time can help you avoid surprises and make your transition much easier.

😁 Have Medicare Questions? We’re Here to Help.

If you’re moving to Florida, moving away from Florida, or simply considering a change of address, Life and Med: Medicare Resource Center is here to help you understand what your move could mean for your Medicare coverage.

Life and Med: Medicare Resource Center
📍 216 N. 3rd St., Suite B
Leesburg, FL 34748
📞 352-260-0202

Have Medicare questions? Give us a call or stop by our Leesburg office. We’re here to help make Medicare easier to understand—wherever life takes you.

This article is for educational purposes only and is not legal, medical, or insurance advice. Medicare coverage, Special Enrollment Periods, plan availability, costs, and eligibility can vary based on individual circumstances. Always verify your specific situation with Medicare and your plan before making coverage changes.