Yes, you can work and keep Medicare Part B

Having Medicare Part B does not stop you from working, and working does not stop you from having Medicare Part B. You can be employed full-time, part-time, or self-employed and still use your Medicare coverage. Your work status has no effect on whether Medicare will pay for your medical care.

The only connection between work and Medicare Part B is money: if you are still earning income, you may owe higher premiums for Part B. This is called Income-Related Monthly Adjustment Amount (IRMAA), and it applies based on your income from two years ago, not your current income.

Key Takeaways

  • Working full-time or part-time does not affect your Medicare Part B coverage or your right to use it.
  • If your income is above a certain threshold, Medicare will charge you a higher Part B premium based on your income from two years prior.
  • You report your income on your tax return, and Medicare uses that information automatically — you do not need to tell Medicare separately that you are working.
  • If your income drops significantly due to retirement or job loss, you can request that Medicare recalculate your premium using your current year's income instead.

How income affects your Part B premium

Medicare Part B has a standard monthly premium that most people pay. If your income exceeds a certain amount, you pay more. The income thresholds change each year, and they are different depending on whether you file taxes as single, married filing jointly, married filing separately, or head of household.

Medicare uses your Modified Adjusted Gross Income (MAGI) from your tax return from two years ago. If you worked in 2022, Medicare looked at your 2022 tax return to set your 2024 premiums. This two-year lag means your current work income will not affect your premiums until two years from now.

The higher premiums are divided into income brackets. The more you earn above the threshold, the higher your premium goes — but there is a maximum. You will not pay more than the highest bracket amount, no matter how much you earn.

When to report a change in income to Medicare

You do not need to call Medicare to report that you started working or are still working. Medicare receives your income information from the Social Security Administration, which gets it from your tax return.

You should contact Medicare if your income drops significantly — for example, if you retire mid-year, lose a job, or have a major life change that reduces your earnings. In those cases, you can request a Life-Changing Event review. Medicare will recalculate your premium using your current year's income instead of waiting two years.

To request this review, call Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visit your local Social Security office. You will need to show proof of the income change — a final pay stub, a letter from your employer, or your most recent tax return.

Working while on Medicare and Social Security

If you are receiving Social Security retirement benefits and working, your earnings may reduce your benefits temporarily — but only if you have not yet reached your full retirement age. This is a Social Security rule, not a Medicare rule, and it does not affect your Medicare Part B coverage.

Once you reach your full retirement age, you can earn as much as you want without any reduction to your Social Security benefits. Your Medicare Part B will continue regardless of how much you earn.

If you are still working and have not yet signed up for Medicare at 65, you may be able to delay enrollment without penalty if you have health insurance through your employer. This is called the Special Enrollment Period for people with group health plan coverage. You will want to check with your employer's benefits office about your specific situation.

Part B coverage while you work

Your Medicare Part B covers doctor visits, outpatient care, medical equipment, and preventive services the same way whether you are working or retired. There are no restrictions on using your benefits based on your employment status.

If you also have health insurance through your employer, Medicare becomes your secondary payer in most cases. This means your employer plan pays first, and Medicare pays its share of what remains. Your employer's benefits office can tell you how the two plans coordinate.

What to ask your doctor or Social Security

If you are working and have questions about how your income might affect your Medicare costs, ask your doctor's office or call Social Security directly. Social Security handles all income-related premium calculations and can tell you whether a change in your income will affect your premiums.

If you are considering retiring or changing jobs, it is worth asking Social Security whether a Life-Changing Event review makes sense for you. They can explain whether your specific situation qualifies and what documents you will need.

Frequently Asked Questions

Will my employer know I have Medicare?

No. Your employer does not receive information about your Medicare enrollment. If you have health insurance through your job, you can coordinate it with Medicare without your employer knowing you have Medicare.

Can I work past 65 and delay Medicare?

Yes, if you have health insurance through your employer. You can delay Medicare Part B enrollment without penalty as long as you are covered by an active group health plan. Once you leave that job or lose the coverage, you have eight weeks to sign up for Part B without penalty.

Does working affect my Part B deductible or copays?

No. Your deductible and copays are the same whether you work or not. Only your monthly premium may increase based on income.

What if I go back to work after retiring?

Your Medicare Part B continues without interruption. If your new income is significantly higher, your premium may increase starting two years later. You can request a Life-Changing Event review if your income drops again.

Do I need to tell Medicare when I retire?

You do not need to tell Medicare, but you should tell Social Security if you are receiving benefits, because your earnings may affect your benefits before full retirement age. Once you reach full retirement age, you can work without any effect on Social Security or Medicare.