Nearing Medicare Age and Still Working

Turning 65 comes with a lot of excitement and reflection. As the milestone approaches, your mailbox and inbox fill up not only with birthday messages but a flood of communication about Medicare.

All the information surrounding Medicare can be overwhelming. So, what’s the best first step for those approaching 65 who are still working?

Where Do You Start When Choosing a Medicare Plan?

Talking with trusted friends and family members about their Medicare choices can start you thinking in the right direction, but it’s important to consider your own health journey and personal health needs, which vary a lot from person to person.

These are some points to consider:

• How often you visit the doctor or need a specialist
• Prescription medication costs and coverage options
• Potential emergency medical expenses
• Whether you travel frequently and need nationwide coverage
• The financial risk of high out-of-pocket costs
• Your long-term health care needs — will your plan still meet your needs in five years?

To help you make a decision that will best fit your budget and priorities, Heather Clay, a product manager with Avera Health Plans, recommended turning to trusted resources for guidance.

Agencies like Medicare.gov provide all you need to know about enrollment periods and Medicare parts so you can be sure you’re up to speed on timelines and guidelines.

A licensed agent from your community can help you understand the unique situation that’s in front of you and steer you toward an option that’s tailored to your needs.

“Avera Health Plans is a great website to start with — our expert agents are all licensed and available to answer any questions,” said Clay.

Should You Enroll in Medicare if You’re Still Working?

For many who are on group insurance, turning 65 is a qualifying life event — an event that allows you to enroll in or change your health insurance plan — so it’s a great opportunity to compare what your options are. Those in the workforce can choose to enroll in Medicare or delay enrollment. Talk with your employer to confirm whether turning 65 is a qualifying life event for your group plan.

You can stay on your health coverage from your employer if that’s the best health care and financial option for you, but you are eligible to sign up for Medicare once you turn 65 and can stay working at the same time, according to Clay.

“You can be on Medicare and you can work as long as you’d like. If you love your job, you don’t have to stop. That’s the nice part,” said Clay. “You have the option to do it or not to do it.”

That’s where sitting down with a trusted agent to talk through your options is helpful.

“You should really look at finances. What is your deductible? What is your max out-of-pocket? What are your prescription needs?” said Clay. It’s also important to understand when you are — and when you are not — eligible for guarantee issue with no health care questions asked, especially if you have a major issue in your health history. These factors will help determine which option is most in line with your health care needs and financial situation.

Medicare Supplement Plans & Medicare Advantage

Medicare doesn’t cover everything and can result in unexpected out-of-pocket costs, so enrollees often consider supplemental coverage.

One option is Medicare Advantage, which operates similarly to a traditional health plan with deductibles, co-pays, coinsurance and a maximum out-of-pocket limit. While these plans may appear cost-effective up front, hidden expenses can add up quickly. Some potential costs include higher out-of-pocket maximums, out-of-network charges and increased co-pays. With Medicare Advantage, co-pays, deductibles and coinsurance may vary by service, and there may be restrictions on where you receive care and which doctors you can see depending on the plan you choose.

Medicare Supplement insurance, on the other hand, offers a fixed monthly premium with little to no unexpected costs, as well as coverage that travels with you, which is ideal for frequent travelers. These plans can also include value-added services such as gym membership discounts and enhanced benefits such as heart and vascular screenings.

“We recommend you do your homework and understand the differences,” Clay said. “The best solution for you may be different from someone else you know.”

Travel Plans? Choose a Wide Network

A major factor to consider when choosing a supplemental plan is the size of the network.

For example, Medicare Supplement AgilityPlus Standard Plans through Avera Health Plans give members access to any Medicare-approved provider or hospital nationwide, which is especially important for those who travel often.

Benefits of Local, Trusted Agents

You don’t have to sacrifice personalized service and local care in exchange for far-reaching coverage. Some plans, such as Medicare Supplement AgilityPlus Standard Plans, combine expertise from agents in your own community with a nationwide network.

“Choose a carrier you can trust to take care of you at a time in your life when you deserve to relax and enjoy yourself,” said Clay.

Still Have Questions?

Talk to a local, trusted agent about your Medicare options.

Find an Agent

BLOG-1302700

© 2025 Avera Health Plans, All Rights Reserved. Network restrictions apply with Select plans. A Plan G policy may not cover all of your medical expenses. Neither Avera Health Plans nor its agents are connected with Medicare or state or federal government.