How Do I Apply For Medicare?

The way in which you apply for Medicare depends on your situation.

Which of the following situations applies to you?

1. I am turning 65 in the next 6 months. I am collecting Social Security monthly benefits and I want to start full Medicare when I am eligible on the 1st day of the month in which I turn 65.
2. I am turning 65 in the next 6 months. I am NOT collecting Social Security monthly benefits and I want to start full Medicare when I am eligible on the 1st day of the month in which I turn 65.
3. I am 65 years old or older and am losing employer health insurance either through myself or my spouse in the next 6 months.
4. I am 65 years old or older and currently have employer health insurance either through myself or my spouse but would like to leave that insurance and switch to full Medicare.

Scenario #3: 

I am 65 years old or older and am losing employer health insurance either through myself or my spouse in the next 6 months 

If you are 65 years old or older and are losing coverage you have through an employer or though your spouse’s employer - either voluntarily or involuntarily - you will have a Special Election period to enroll in Medicare Part B and, if you do not already have Medicare Part A, then Medicare Part A also.

The following are the four steps you must take to enroll in Medicare Part B - and Medicare Part A if you do not already have Medicare Part A - when you are leaving employer coverage.

1. You need to contact your local Social Security office via phone and tell them you need to enroll in Medicare Part B due to your leaving employer health insurance.  We highly recommend calling your local Social Security office rather than the national toll-free number. Also, please write down the name of the person with whom you speak in the event you need to refer back to the call at a later occasion. If you do not already have Medicare Part A you will be automatically enrolled in Medicare Part A when you enroll in Medicare Part B.

2. You will need to have your employer complete and sign Employer Form CMS-L564E.  You can download this form by clicking on this link.  This form will document that you have had health insurance through your employer since you were eligible for Medicare and when this coverage is ending.  If both you and your spouse are leaving the employer coverage, you will need to have a separate form completed and signed for each of you.

3. You will need to complete and sign Form - CMS40B-E. You can download this form by clicking on this link. This is your application for Medicare Part B.  If both you and your spouse are enrolling in Medicare Part B, you will need to have a separate signed for each of you.

4. You will need to mail or fax these completed and signed documents to your local Social Security office at the address or fax number you are provided in Step 1 above.

Scenario #4: 

I am 65 years old or older and currently have employer health insurance either through myself or my spouse but, though I am not leaving this my employer, I would like to leave their insurance and switch to full Medicare.

If you are 65 years old or older and wish to leave your employer health insurance to go on full Medicare, you can do this at any time. You do not need to wait until either your employer’s yearly election period or Medicare’s Annual Enrollment Period.

You will have a Special Election period to enroll in Medicare Part B and, if you do not already have Medicare Part A, then Medicare Part A also.

You should follow the steps prescribed in Scenario #3 above.

Very importantly, federal law prohibits your employer from encouraging you to leave their insurance to go on full Medicare - including by providing financial incentives to do so.  This is a decision you should make on your open based on your unique needs and preferences.