You may qualify for an SEP if:
- You are covered under a group health plan (GHP) based on current employment (your own, a spouse's, or sometimes a family member's).
- You are enrolling during the 8-month period that begins the month after your employment or the employment on which your GHP coverage is based ends, whichever comes first.
Important Documents: CMS 40B and CMS L564
To enroll in Medicare Part B during an SEP, you will need to complete and submit the following documents:
- CMS 40B: Application for Enrollment in Medicare Part B (Medical Insurance). This form is used to sign up for Medicare Part B if you already have Part A.
- CMS L564: Request for Employment Information. This form is used to document your employer-provided health insurance coverage.
Enrollment Options
You have several options for enrolling in Medicare Part B:
- Online: You can enroll online through the Social Security Administration's website.
- In Person: You can visit your local Social Security office to enroll in person.
- By Paper Document: You can fill out the necessary forms and mail them to the Social Security Administration.
Recommended Enrollment Method
While there are multiple ways to enroll, we recommend taking the CMS 40B and CMS L564 forms to your local Social Security office in person. This ensures that your documents are received and processed promptly, and you can get immediate assistance if any issues arise.
Coverage Start Dates
The start date of your Medicare Part B coverage will default to the first of the month following your enrollment. However, you can delay your coverage start date by up to three months. Here’s how you can manage this:
- Default Start Date: Your Medicare Part B coverage will automatically begin on the first day of the month following your enrollment.
- Delaying the Start Date: You can delay your coverage start date by up to three months.
- How to Delay: Enroll up to three months in advance and specify your desired effective date in Section 9 - Remarks of the CMS 40B form.
- For example, write "requesting MM/01/YYYY effective date" to indicate the month you want your coverage to begin.
This flexibility allows you to better align your Medicare Part B start date with your personal circumstances and any existing health coverage.
Important Consideration for Medicare Advantage Plans
If you plan to enroll in a Medicare Advantage (MA) plan and there is more than a three-month gap between the effective dates of Medicare Part A and Part B, the effective date of your MA plan must align with the effective date of your Part B coverage. This coordination ensures that your MA plan coverage starts simultaneously with your Medicare Part B coverage.