Enrolling in Medicare Part B: Planning for Medicare if You Worked Past 65

You likely became eligible to receive Medicare benefits when you turned 65, but opted to delay your enrollment in Part B in favor of maintaining your creditable coverage while you continued working. As you approach retirement, it’s time to learn how to receive your Medicare Part B benefits and enroll properly. To ensure you don’t have any gaps in health coverage or incur any late enrollment penalties, let’s walk you through the ways to sign up for Medicare Part B after turning 65.

Creditable Coverage and Your Special Enrollment Period

Recent statistics issued by the U.S. Bureau of Labor Statistics indicate that almost 27% of the workforce is over the age of 65. While the majority of Medicare-eligible beneficiaries enroll when turning 65, delaying your Medicare Part B enrollment will require some additional steps when you choose to retire. Such individuals can avoid penalties because they’ve maintained creditable health coverage through their employer, union or the U.S. Department of Veterans Affairs. Simply, if an individual’s employer has over 20 employees, then their plan meets the Medicare standards of care and delaying Part B enrollment is acceptable.

Working past 65 creates its own set of rules and guidelines when applying and enrolling in Part B Medicare. Since you’ve passed your 65th birthday and your Initial Enrollment Period by delaying retirement, losing your employer coverage creates a Special Enrollment Period (SEP), which allows you to enroll in Medicare Parts A, B, C and D penalty-free. You also can enroll in a Medicare supplement plan during this enrollment period. An SEP, by definition, allows Medicare-eligible individuals and current enrollees, the opportunity to enroll or change their Medicare benefits. Medicare grants an SEP for loss of employer coverage and it is important to enroll during this window, or you could face lifetime penalties and gaps in your health insurance coverage.

How to Enroll in Medicare Part B

To apply for Medicare under an SEP, such as loss of employer group health insurance, you must prove you have a qualifying special circumstance. The Social Security Administration has a specific form for you to use to complete your enrollment request into Part B under an SEP. The form is referred to as the CMS-L564, and you will need to work with your HR department to complete it properly. By completing this form, your employer is certifying that you’ve had creditable health coverage during the period prior to age 65 through the date of completion. By completing this form and proving you had creditable health coverage, you also avoid penalties for delaying your Medicare Part B and Part D benefits.

The best way to complete your form is to forward the CMS-L564 form to the staff member or department (usually human resources) that handles insurance-related matters. They can complete the form, sign it and send it back to you. It is recommended they send it to you in a digital format (PDF is best), so you can easily submit it for processing.

Your SEP will technically begin the day after your loss of employer coverage; however, we recommend beginning enrollment preparation prior to your actual loss of insurance to avoid any gaps in coverage. We recommend you begin evaluating your coverage options and starting the enrollment process 90 days before you will leave the employer coverage. Starting early also allows you to use this time to make decisions about additional benefits, like Medicare Advantage, Medicare supplement and Medicare Part D.

To help you in submitting your application to the Social Security Administration (SSA), your options are as follows:

1. Submit your application in person, or via mail or fax

To properly apply for Medicare Part B during your SEP, you will need two forms. As previously mentioned, you need a completed CMS-L564 as well as a CMS 40B, which is the Medicare Part B application. You can send these forms in via U.S. mail, fax or go in-person to your local SSA office.

2. Apply for Part B online

The easiest way of enrolling in Part B is to use SSA’s online webpage specifically designed to accept applications for individuals applying due to loss of employer coverage. You can find this page by clicking here. You can also get to the link by navigating to the Social Security website, selecting “Medicare” from the navigation bar, then “Already Enrolled in Medicare” (you should already be covered by Medicare Part A) in the left hand menu.

Medicare Enrollment Assistance from Licensed Agents

If you’re approaching retirement and need assistance transitioning into Medicare, including applying for Part B, contact one of our licensed Medicare insurance agents at Medicare Portal. Our team is available to speak with you over the phone, online or in-person to assist you in navigating your Medicare enrollment process and decisions. The good news is our no-cost services and support do not end with enrollment. We are committed to providing you lifetime support for all your Medicare needs. Contact us today for assistance.

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