Enrolling in Medicare Part B in Your 70s
Congratulations! You’ve worked past 65 and – because you’ve had acceptable coverage through an employer or in some cases the military – you were able to delay enrolling in Medicare Part B. But now that coverage is ending.
I’ve run into this situation three times just this week. In this post we’ll walk through how to get going on Medicare Part B.
The Bottom Line
You are going to need two forms:
This form must be completed by your employer. This provides documentation to Social Security that you’ve had health coverage since age 65 with no gaps greater than eight months.
A few options:
Print and deliver the paper copy to your HR representative to complete and return back to you.
Email the above linked form to your HR representative and ask them to return a completed PDF back to you.
This simple, 1/2-page form will be completed by you.
This is available as a PDF form or an online web form.
Your two options:
Complete the form and mail or fax the form back to your local Social Security office. Make sure you include Form CMS-L564 completed by your employer.
Depending on your comfort with computers, completing the form on the web may be the easier option. At the end of the web form you will be asked to upload the completed CMS-L564 from your employer. Make sure you have that ready to go as a PDF.
What About My Spouse?
You’ll need to fill out the forms above twice if your spouse is coming off your group coverage with you. Get two CMS-L564 forms filled out by your employer: one for you and one for your spouse. Then complete a CMS-40B for both you and your spouse. Submit all four forms to your local Social Security office or use the online web form.
When to Get Enrolled
Leaving employer group coverage creates an eight-month Special Enrollment Period (SEP) to sign up for Medicare Part B (and a Part D prescription drug plan).
I recommend enrolling in Medicare Part B in the three months leading up to leaving your group coverage. Your Medicare Part B coverage will begin the first day of the month you sign up, or you can set your effective date to any of the three months following.
Now you may not want your employer to know you are retiring quite yet. In that case, rest easy knowing your Medicare Part B coverage will begin the first day of the month you sign up. No rush.
And if you’ve already left your group coverage? Your eight-month SEP window to sign up begins the first full month after that coverage ends. Get moving to avoid future penalties and delays! Reach out for help.
Special Note on COBRA
COBRA coverage following employment does not delay your need to enroll in Medicare Part B. Your eight-month special enrollment period begins when your employment ends, not when COBRA coverage ends.
On COBRA, Medicare would be your primary insurance and COBRA secondary. In this case, it is likely a greater value and benefit to have a Medicare Supplement and decline COBRA. The exception to this would only be if you are on expensive prescription medication. Reach out to discuss your best options.
Special Note on Keeping Any "Notice of Creditable Coverage"
Employer group plans are required to proved an annual Notice of Creditable Coverage" to employees that are eligible for Medicare Part D prescription drug coverage. You should keep this when you receive it, generally in September.
Once you get on Medicare, you will likely get a Part D Prescription Drug plan. When you do, the insurance company will ask you submit the Notice of Creditable Coverage from your former coverage in order to avoid a penalty.
Closing
Social Security, like the IRS, can be intimidating with form names like “CMS-L564”, but rest easy. Two simple steps and you’re on your way to Medicare Part B after retirement.
You can get these forms to your local Social Security one of four ways:
- Hand deliver
- Fax
- Online application
Once you’re enrolled, reach out to me to complete your coverage. Medicare Part A has a $1408 deductible for each inpatient trip to the hospital and Part B leaves a 20% gap. Original Medicare also does not cover prescription drugs. I will work with you to cover these with supplemental insurance.
If you have any questions at any time about this process, call or email me. I’d be happy to walk with you through the process.