Should you take Part A at 65 if you're still working?

Why most people take premium-free Part A at 65 even with employer coverage, the HSA exception, and how Part A coordinates with a job plan.

If Part A is free for you, signing up at 65 usually makes sense even if you have health insurance through work. It can act as secondary coverage for hospital bills.

The HSA exception

You can't contribute to a Health Savings Account once any part of Medicare starts. If you or your employer contribute to an HSA, you may want to delay Part A. Remember Part A is backdated up to six months when you sign up after 65; see HSAs and Medicare.

Social Security and Part A

If you start Social Security at 65 or later, Part A starts automatically. You can't keep Social Security and decline Part A.

Part B is a separate decision

Whether to delay Part B depends on the size of your employer and whether coverage comes from current work; see employer coverage after 65.

Questions people ask

Should I take Part A at 65 while working?

Usually yes, if it's premium-free and you don't contribute to an HSA.

Can I contribute to an HSA with Part A?

No.

Does Social Security start Part A?

Yes, if you're 65 or older.

Is Part B the same decision?

No, Part B depends on your employer coverage.

Independent educational site. Not affiliated with or endorsed by the U.S. government, the federal Medicare program, or any insurance company. Figures are 2026 amounts published by CMS unless noted; check Medicare.gov for your situation.