In short
- Douglas County had 93,667 residents 65 and older in July 2025, up 16.9% since 2020.
- Omaha's largest employers, such as Nebraska Medicine, Union Pacific and Mutual of Omaha, have far more than 20 workers, so coverage from a current job there pays before Medicare.
- After you leave a job at 65 or older, you have 8 months to add Part B, but only 2 full months after coverage ends to join a drug plan.
- COBRA and retiree coverage do not count as current employment. The 8-month clock starts when the job ends.
- Military retirees generally must take Part A and Part B to keep TRICARE. Union Pacific retirees enroll through the Railroad Retirement Board.
Between 2020 and 2025, Douglas County's 65-and-older population grew 16.9%, from 80,110 to 93,667 (Census Bureau, July 1 estimates). What sets Omaha apart is where many people work as they approach 65. The metro's biggest employers are large enough that their health plans pay before Medicare, which changes when you need Part B and how you leave a job. This page covers that Omaha situation. The statewide turning 65 checklist covers the basic seven-month sign-up window.
Can you delay Part B if you work for a big Omaha employer?
Usually, yes. When you are 65 or older and covered by a group plan through current work at an employer with 20 or more employees, that plan pays first. You can delay Part B without a penalty. The same is true if the coverage comes through a working spouse.
Greater Omaha's largest employers all clear the 20-employee line easily:
| Employer size (Greater Omaha Chamber) | Employers |
|---|---|
| 5,000 or more workers | Offutt Air Force Base, Nebraska Medicine, CHI Health, Omaha Public Schools, UNMC |
| 2,500 to 4,999 workers | Methodist Health System, First National Bank of Omaha, Fiserv, Mutual of Omaha, Union Pacific, Children's Nebraska |
Offutt works differently for active-duty members, who have TRICARE (see below). Two more cautions. Get the plan's rules for members 65 and older in writing from your benefits office. And if you contribute to a Health Savings Account, signing up for any part of Medicare ends your ability to contribute. The working past 65 page and the employer coverage vs Medicare comparison go deeper.
What does the timeline look like when you retire from an Omaha employer after 65?
Tighter than most people expect, because the drug plan deadline comes six months before the Part B deadline. Here is a dated example: you are 66, and your coverage at a large Omaha employer ends June 30, 2027.
| Step | Deadline in this example |
|---|---|
| Apply for Part B while still covered and ask for a July 1 start | May or June 2027 |
| Part B Special Enrollment Period (8 months) | July 2027 through February 2028 |
| Join Medicare Advantage or a Part D plan | By August 31, 2027 (2 full months after coverage ends); ask the plan about a July 1 start |
| Medigap open enrollment (6 months from Part B start) | July 1 through December 31, 2027 |
Medicare lets you ask for your Part B start date to be delayed up to three months if you sign up while still covered or in the first full month after coverage ends. That is how you line up Part B with your last day on the employer plan.
What do Offutt, Union Pacific and OPS retirees need to know?
Each has its own wrinkle.
- Offutt and other military retirees: Medicare & You 2027 says people with TRICARE generally must sign up for Part A and Part B when first eligible to keep TRICARE. Active-duty members and their families are the exception for Part B. See Medicare for veterans for how TRICARE For Life fits.
- Union Pacific retirees: Union Pacific is headquartered in Omaha, and railroad workers enroll through the Railroad Retirement Board, at RRB.gov or 1-877-772-5772. Railroad Medicare processes Part B claims.
- Omaha Public Schools retirees: your pension is paid through the Omaha School Employees plan, now administered by NPERS in Lincoln. The pension office is not your health plan, so ask the district's benefits office how any retiree coverage works with Medicare.
How do you choose between a supplement and Medicare Advantage in Omaha?
Start with your doctors. Omaha care is split among Nebraska Medicine, Methodist and CHI Health, and Douglas County has 24 standard Medicare Advantage plans from six companies for 2027, each with its own network. If you want to keep seeing doctors across more than one system, or across the river in Iowa, Original Medicare with a Medigap policy avoids the network question entirely.
Timing decides how easy that choice is. Your six-month Medigap open enrollment window starts with Part B. Inside that window, no company can refuse you or raise your price over a health condition. Nebraska has no birthday rule, so once it closes, medical underwriting is allowed. The Omaha Medicare Supplement page covers Omaha pricing, and the Omaha Medicare Advantage page covers the 2027 plan lineup.
Where can people turning 65 in Omaha get help?
You have neutral options close to home:
- Volunteers Assisting Seniors at 900 S 74th Plaza, Suite 403 (402-444-6617). It is the Omaha office for Nebraska SHIP, the state counseling program formerly called SHIIP, which also answers statewide at 1-800-234-7119.
- ENOA, the Eastern Nebraska Office on Aging, 4780 S 131st St. Information and Assistance: 402-444-6444.
- Social Security, at SSA.gov/medicare/sign-up, for Part A and Part B applications.
- 1-800-MEDICARE (1-800-633-4227), which answers 24 hours a day, 7 days a week. The TTY number is 1-877-486-2048.
Bill works with Omaha residents by phone and video from Lincoln, about 65 minutes down I-80, and meets at his office whenever you are in town. About four months before your birthday or your last day at work, talk to Bill.
Frequently asked questions
Usually not yet. If your employer has 20 or more employees and you are covered because you are still working, the group plan pays first and Medicare pays second. Part B can wait, with no penalty, until an eight-month Special Enrollment Period that opens when the job or coverage ends. Some people still take Part A at 65, since most pay no premium for it, but not if they want to keep contributing to an HSA.
Yes, the same rule applies to coverage through a working spouse. If the plan is based on your spouse's current employment at a company with 20 or more workers, you can usually delay Part B without a penalty. When your spouse retires or the coverage ends, you have eight months to sign up. Ask the benefits office in writing how the plan treats members who are 65 or older.
No. COBRA is not coverage based on current employment, so it does not extend your Part B Special Enrollment Period. The eight months start the month after your job or coverage ends, whichever comes first, whether or not you take COBRA. If you are 65 or older and eligible for Medicare, Medicare pays first and COBRA may pay only a small part of your bills.
Through the Railroad Retirement Board instead of Social Security. Apply online at RRB.gov, or by phone at 1-877-772-5772 (TTY 1-312-751-4701). If you already get RRB benefits, Part A and Part B generally start automatically at 65. Part B claims for railroad retirees go to Railroad Medicare, but Medigap and Part D plans work the same way.
Volunteers Assisting Seniors at 900 S 74th Plaza, Suite 403, is Omaha's Nebraska SHIP office (402-444-6617). ENOA, the Eastern Nebraska Office on Aging, runs an Information and Assistance line at 402-444-6444. Bill Jurey, an independent agent based in Lincoln, also meets with Omaha residents by phone or video, and carriers, not clients, pay for his help.
Sources
- Medicare & You 2027 handbook (opens in a new tab)
- Medicare.gov: Who pays first (opens in a new tab)
- Medicare.gov: Special Enrollment Periods (opens in a new tab)
- Greater Omaha Chamber: Largest employers (opens in a new tab)
- U.S. Census Bureau: Vintage 2025 county population by age, Nebraska (opens in a new tab)
- Eastern Nebraska Office on Aging (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
