Ask Terry Questions Medicare and HSA

Medicare and HSA

By Terry Savage on September 10, 2026 | Insurance & Annuities

My husband is a union carpenter supervisor and intends to work until 67. He is 65 and was told he needed to enroll in Medicare part A because he is 65 even though he is still working. Now he is enrolled in part A which we are learning from your show on WGN today he should not have enrolled. We are concerned about what this will now do to his health savings plan at work and his other plans. What do we do now? He enrolled in April. He turned 65 in January. Thank you for your help.

Terry Says

Who told him he must enroll? It was likely a very costly error — even through Part A is free. Once enrolled, even in free Part A, you can no longer contribute to a Health Savings Account!
Only small businesses with fewer than 20 employees are allowed to require Medicare Part A as a primary coverage. That applies to unions as well. Here are the specifics re unions and Medicare:
Large Employer (20+ Employees): If your employer has 20 or more employees, or your union health plan is a multi-employer plan where at least one employer has 20+ employees, your employer/union plan pays first and Medicare is secondary

Quickly see if he can disenroll in Part A. If it was just a few weeks ago, he might be able to get out, and continue making HSA contributions. Read this: https://www.medicarefaq.com/faqs/hsa-and-medicare/

And he should find that person who led him astray and set him/her straight before other people take this bad advice!

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