If you’re approaching age 65 and still working — or covered under a spouse’s employer plan — you may be wondering whether you should enroll in Medicare or keep your employer coverage. This is one of the most common (and confusing) Medicare questions we hear.

The truth is: there is no one-size-fits-all answer. The right choice depends on your employer plan, your health needs, and your long-term costs. Making the wrong decision can lead to higher premiums, coverage gaps, or late enrollment penalties.

Here’s how to know which option may be right for you.

Understanding Your Medicare Options at Age 65

When you turn 65, you become eligible for Medicare, which includes:

  • Medicare Part A (Hospital Insurance) – Often premium-free

  • Medicare Part B (Medical Insurance) – Monthly premium required

  • Medicare Part D (Prescription Drug Coverage) – Optional but important

  • Medicare Advantage or Medicare Supplement plans – Additional coverage options

Even if you’re still working, you must actively decide whether to enroll in Medicare or delay it based on your situation.

When Employer Coverage May Make Sense

You may be able to delay Medicare enrollment without penalty if:

  • You or your spouse are actively working

  • You are covered by an employer plan from a company with 20 or more employees

  • The employer coverage is considered creditable (especially for prescription drugs)

In this case:

  • You can usually delay Part B and Part D

  • You won’t face penalties when you later enroll

  • You’ll qualify for a Special Enrollment Period when coverage ends

However, employer coverage isn’t always better — even if it feels familiar.

When Medicare May Be the Better Choice

In many cases, Medicare can actually provide better coverage at a lower cost.

Medicare may be the right move if:

  • Your employer has fewer than 20 employees

  • Your employer plan has high deductibles or premiums

  • You see doctors frequently or take multiple prescriptions

  • Your spouse is retiring and coverage will end soon

Medicare combined with a Supplement or Advantage plan can often reduce:

  • Out-of-pocket costs

  • Prescription expenses

  • Unexpected medical bills

Key Factors to Compare Before Deciding

Before choosing Medicare or employer coverage, you should compare:

1. Monthly Premiums

Employer plans often appear “free” — but payroll deductions add up. Medicare costs are more transparent.

2. Deductibles & Out-of-Pocket Costs

Employer plans may have higher deductibles and coinsurance than Medicare-based plans.

3. Prescription Drug Coverage

Not all employer plans are considered creditable. This matters for avoiding Part D penalties.

4. Provider Access

Medicare offers broad provider access nationwide — helpful for retirees who travel or see specialists.

5. Future Flexibility

Enrolling at the right time protects you from lifelong late enrollment penalties.

Avoiding Costly Medicare Enrollment Mistakes

Some of the most common mistakes we see include:

  • Assuming employer coverage is always better

  • Delaying Medicare without confirming creditable coverage

  • Missing enrollment windows

  • Enrolling in Part A only when Part B is required

  • Not understanding how Medicare works with employer insurance

These mistakes can result in permanent penalties or coverage delays.

How Lehigh Valley Medicare Advisors Can Help

Choosing between Medicare and employer coverage isn’t just about today — it’s about protecting your healthcare and finances for years to come.

At Lehigh Valley Medicare Advisors, we:

  • Review your employer plan in detail

  • Compare it side-by-side with Medicare options

  • Explain penalties, timelines, and enrollment rules clearly

  • Help you make a confident, informed decision — at no cost

Final Thoughts: Get Guidance Before You Decide

If you’re turning 65 or approaching retirement, don’t guess when it comes to Medicare. The right decision depends on your specific situation — and getting it wrong can be expensive.

Make an Appointment with Lehigh Valley Medicare Advisors today for a personalized Medicare vs. employer coverage review and get clarity before making your choice.