For agents selling Medicare plans, the stereotypical prospect has been someone with graying hair, approaching the age of 65 or already past it, and retired. In reality, there are plenty of beneficiaries who don’t fit this stereotype. However, you’ve probably noticed more of them lately.
Those working past age 65 are still eligible for Medicare and could benefit from your services as an agent. How could their health coverage differ from those not working? Read on to find out.
Turning 65 and Still Working?
Traditionally, getting to the big 6-5 has meant two things:
- You’re now eligible for Medicare based on your age
- You’re able to retire with full benefits
While this milestone birthday still marks the age of Medicare eligibility, it’s no longer the Social Security full-benefit retirement age. For those born in 1962 (and turning 65 next year), the full-benefit retirement age is 67 years.
Nearly one in five Americans aged 65 or older are still working. The number of seniors in the workforce not only affects said seniors, but also those who closely work with this population. If you’re an insurance agent who sells Medicare plans, it’s time to consider how you need to adjust to better serve your clients and their changing needs.
How Insurance Agents Should Advise Clients Turning 65 While Still Working
If your client is receiving health coverage from an employer with 20 or more employees, they have options. They don’t have to switch to Medicare. They could delay Medicare Parts A and B without penalty.
Your client could also sign up for Original Medicare. However, it’s probably not worth it for them to pay for Part B since their employer coverage would be the primary payer. Employer-sponsored health insurance is generally more affordable and comprehensive because employers often subsidize a significant portion of the premiums.
This isn’t always the case, as family coverage or individuals who qualify for subsidies in the ACA marketplace generally have them seeking other options. It’s more of a 50-50 chance that clients may save money by leaving employer coverage nowadays.
As the agent, you could help your clients decide based on the following considerations:
- How much would Part B cost them with IRMAA involved?
- What is the cost of Medicare Supplement and prescription drug coverage?
- What is the cost of dental and vision on top?
Then, you could compare those costs to your client’s premium through their employer. It’s important to remember to take any deductibles that employer coverage has into consideration as well.
If your client qualifies for premium-free Part A, they should probably enroll in that as it provides no-cost, comprehensive:
- Inpatient hospital coverage
- Skilled nursing facility care
- Hospice
- Some home health services
Is your client receiving employer coverage from a company with fewer than 20 employees? The employer could require the client (and their spouse, if the spouse is on the insurance) to switch over to Medicare once they’re eligible. If this happens, Medicare will likely act as the primary payer and the employer plan will pay secondary.
How Insurance Agents Can Help Medicare Clients Rejoin the Workforce
Nearly one in eight of U.S. workers aged 65 or older rejoined the workforce in 2026. If a client with Medicare “unretires” they’ll have to decide if they want to transition to employer coverage, keep their Medicare plan, or both.
It’s important to be aware, and make your client aware, that, if they decide to unenroll from Medicare Part B when they, or their spouse, rejoin the workforce, they may have to pay a penalty when they re-enroll in it later.
The exception would be if they get a Special Enrollment Period to join Medicare Part B after their employer coverage ends.
Nearly one in eight of U.S. workers aged 65 or older rejoined the workforce in 2026.
Explain How to Sign Up for or Delay Medicare Parts A and B
With your clients possibly making changes to their coverage, you’ll want to be sure they know how to do it. You don’t want a client assuming their Medicare coverage will start, or be delayed, automatically. Your clients should contact their local Social Security office for assistance in enrolling in or dropping Medicare coverage.
Let your client know that, if they receive their Medicare card in the mail, they can delay enrollment by following the instructions for sending back their Medicare card, which should come with the card.
Tell Clients When Their Medicare Supplement OEP Occurs
During one’s Medicare Supplement (or “Medigap”) Open Enrollment Period (OEP), they don’t have to pass underwriting to enroll in a Medicare Supplement plan, which is fantastic if they have chronic health conditions. Additionally, they cannot be charged more for their plan if they have health problems.
Clients will be eligible for a 63-day period to enroll in a Med Supp plan if:
- Your client has employer coverage
- There are less than 20 employees at the company
For a client with employer coverage through a company with more than 20+ employees, or one without employer coverage, their Medicare Supplement OEP should start when they sign up for Part B. People who miss this OEP likely won’t be able to enroll in a Medicare Supplement plan with guaranteed issue rights.
People who miss this OEP likely won’t be able to enroll in a Medicare Supplement plan with guaranteed issue rights.
How Insurance Agents Can Help Clients Avoid Medicare Late Enrollment Penalties
Late enrollment penalties can exist for Medicare Part A, B, and D. Whether or not someone incurs a penalty depends on their unique situation, mainly:
- Whether they have employer coverage and what kind
- The size of their employer
- When they sign up for Medicare
If a client incurs any penalties, they’ll pay them for the rest of the time they’re on Medicare. The penalties may only be a few extra dollars a month, but they’ll add up over time!
Important Note: A spousal benefit is no longer considered credible to delay Part B enrollment if the employee is retired. It only counts if they are actively working.
How Insurance Agents Can Support Clients Transitioning to Medicare
As clients near retirement age, they start receiving a lot of mail and important papers. To stay at the forefront of your clients’ minds, we recommend reaching out to clients who are 64 and letting them know that postponing their retirement may affect their Medicare enrollment deadlines.
To rise above the noise even more, consider giving your clients a unique way to remember you. Don’t just hand them a business card or flyer that could get lost among all the other papers they’re receiving.
Give them something with your info on it that’s harder to lose, like a backscratcher, fly swatter, or magnet! You could also consider organizing a seminar for your clients who are nearing age 65.
Don’t just hand them a business card or flyer that could get lost among all the other papers they’re receiving. Give them something with your info on it that’s harder to lose!
Why Insurance Agents Should Avoid Assumptions About Working Medicare Clients
By now, you know it’s important not to assume your clients will leave their job once they turn 65, or that they’ve already left their job if they’re over 65.
If they’re still working, don’t assume that it’s full-time, and don’t assume they have employer coverage. Don’t assume that a client who isn’t working doesn’t have employer health coverage. They may have it through a spouse.
How can you avoid making assumptions like these and others? Ask your clients specific questions that get you the information you need to help the client and serve them best.
As an agent, you are already likely assisting clients in all walks of life, all ages, incomes, and health backgrounds. Just because someone may fit the mold for a product based on one factor, like their age, it doesn’t mean that product is the right solution for them at that time.
Working trends are changing and more seniors are working longer. Be cognizant of this change and shift your business strategy to be well ahead of the curve!
Ritter can help you with that! Registering for free today gives you access to essential tools, resources, and back-office support to assist you with any of your business needs.
Not affiliated with or endorsed by Medicare or any government agency.
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