Medicare Special Enrollment Form Changes
Today’s video and associated copy is only relevant to those who are planning to go on Medicare Part B during a Special Enrollment Period. The change that we discuss below puts more responsibility on the individual applying for Medicare Part B during a Special Enrollment. We want people to be aware of this, especially since June 30 is upon us and is a common retirement date. Most people who work beyond age 65 and for a group of twenty or more employees, and their eligible spouses, should plan to enroll in Medicare Part B through a Special Enrollment Period. The General Enrollment is another option but can be associated with premium penalties.
The majority of people go on Medicare at age 65 and most of those individuals must apply during their Initial Enrollment Period which begins three months before the month of their birthday and ends three months after the month of their birthday. The only people who are automatically enrolled in Medicare are those who took Social Security prior to turning 65. With few exceptions, Connecticut being a notable one, those who work for a group of under twenty employees should also enroll in Medicare A and B because the group coverage will become secondary if one keeps the group coverage.
If you are enrolling in Medicare within three months before or after your birth month, you will use the Initial Enrollment Period to enroll in Medicare. A Special Enrollment period is only applicable to people who enroll in Part B after their Initial Enrollment Period closes. There are two forms used for a Special Enrollment, CMS L564, which the employer completes, and CMS 40B, which the employee and, if applicable, the employee’s spouse completes. The CMS L564 is what the government accepts as validation of active group coverage. The purpose of the CMS 40B is to request Part B coverage to begin at a certain time. We have included the CMS L564 and CMS 40B forms in the links below:
The information requested on CMS L564, employment start, and end date, and coverage start and end date, is now also being requested on the CMS 40B so they should match. Otherwise, one risks a Medicare application being kicked out and the application delayed. No one wants their Medicare Part B entitlement held up in this way.
Unfortunately, it is all too common for the Employer portion of the form, usually done by someone in Human Resources, to be completed incorrectly. The most common error is putting the start date of coverage through the most recent insurer or the most recent policy renewal date rather than the start date of coverage itself which is almost always around the start date of employment. The form needs to reflect that you had active group coverage since at least age 65 since that is what Social Security needs to see to grant you a Special Enrollment in Part B.
Again, make sure the information pertaining to employment and group coverage is accurate on both forms before submitting them to Social Security (or the Railroad Retirement Board, if applicable). Thanks.
