Are you within three months of turning 65?
Are you 65 or older and losing your health care coverage from your employer?
It may be time to enroll in Medicare!
The SHINE Program can answer your questions on enrolling in Medicare Parts A & B. SHINE counselors can explain the enrollment process and the forms that need to be submitted to Social Security (by visiting a Social Security office, through a phone appointment, by mailing or faxing, or completing an application online). They can also review what your options are for additional medical and prescription coverage beyond Medicare Parts A & B.
Whether you are turning 65 or are aged 65+, you may need to submit the CMS-40B form (ENGLISH), CMS-40B (SPANISH): Application for Enrollment in Medicare Part B.
If you are aged 65+ and leaving your employer group health plan coverage , you will also need to submit the CMS-L564 form (ENGLISH), CMS-L564 (SPANISH): Request for Employment Information. If you have difficulty getting the L564 form completed, you may be able to submit other forms of documentation (such as pay stubs, income tax returns, or receipts showing health insurance premium deductions or payments; W-2s reflecting pre-tax medical contributions; health insurance cards with an effective date; or explanation of benefits paid by employer group health plan).
You have a window of opportunity to sign up for Medicare Part B if you are losing employer-group health coverage that begins three months before you retire; while you have additional time to enroll in Medicare Part B after you leave employer group coverage, you do not want to wait to enroll!
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