Over 65 and currently on an employer plan
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How it works
- To sign up for Medicare when retiring after age 65, you must apply through a Special Enrollment Period (SEP). Because you have been covered by a qualifying employer health plan, this window allows you to enroll without paying a late-enrollment penalty.
- Your SEP lasts for 8 months starting the month after your employment or health coverage ends, whichever comes first.
- If you have a Health Savings Account (HSA), stop all contributions at least 6 months before you apply for Medicare or Social Security. When you enroll in Medicare after age 65, Part A coverage is backdated up to 6 months. Contributing to an HSA during those backdated months triggers strict tax penalties.
Need Part B only
Need Part B only
Need Part B only
If you have are enrolled in Part A only, you will need to enroll in Part B. You cannot simply use the standard online application; you must prove you had continuous employer coverage since turning 65. You will need two specific forms:
- Form CMS-40B (Your Application): Fill this out yourself to request enrollment in Part B. Write "SEP" at the top of the form. You can access it on the official CMS 40B Page.
- Form CMS-L564 (Employer Verification): Fill out Section A, then give it to your company's Human Resources department. HR must complete and sign Section B to verify your health coverage history. Download this from the CMS L564 Page.
Once you have both signed forms in hand, submit them together to the Social Security Administration (SSA):
- Online (fastest): Upload your completed forms directly through the Social Security Medicare Signup Portal.
- Mail or Fax: Send them directly to your local Social Security office, which you can find using the official SSA Office Locator.
Need Part A & B
Need Part B only
Need Part B only
If you have are not enrolled in Part A or B, you must prove you had continuous employer coverage since turning 65. You will need one specific form:
- Form CMS-L564 (Employer Verification): Fill out Section A, then give it to your company's Human Resources department. HR must complete and sign Section B to verify your health coverage history. Download this from the CMS L564 Page.
Once you have both signed forms in hand, submit them together to the Social Security Administration (SSA):
- Online (fastest): Upload your completed forms directly through the Social Security Medicare Signup Portal.
- Mail or Fax: Send them directly to your local Social Security office, which you can find using the official SSA Office Locator.
Next Step
Original Medicare (Parts A & B) does not cover prescription drugs or out-of-pocket deductibles. Within 2 months of your employer coverage ending, you must choose a private insurance supplement to avoid penalties. Our role is to help you evaluate your options and select the plan that best fits your needs.
- Add Drug Coverage (Part D): Original Medicare does not cover prescriptions. You must choose and buy a private Part D plan to avoid future late penalties.
- Choose a Path: Decide if you want to keep Original Medicare and add a Medigap (Supplement) policy, or if you prefer to bundle everything into a private Medicare Advantage (Part C) plan.
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CMS Required Disclaimer Statement per new regulation effective 10/1/2023: "We do not offer every plan available in your area. We work with over 10 major carriers in Minnesota and WISCONSIN and all the plans offered by those carriers. 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." In addition, CMS requires that all Medicare-related "sales" calls are recorded. Thank you for helping us stay compliant so we can continue to serve you!
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