Enrolling In Medicare Parts A & B During a Special Enrollment Period (SEP)

  1. Overview
  2. Original Medicare - Enrollment
  3. Enrolling In Medicare Parts A & B During a Special Enrollment Period (SEP)

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 L564 and CMS 18-F-5

To enroll in Medicare during an SEP, you'll need to complete and submit specific documents:

  1. CMS L564: Request for Employment Information. This form is used to document your employer-provided health insurance coverage.
    https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms-l564e.pdf

  2. CMS 18-F-5: Application for Enrollment in Medicare Part A and Part B. This form is used to apply for both Medicare Part A and Part B if you do not already have Part A.
    https://www.cms.gov/files/document/cms-18-f-5-application-part-hospital-insurance.pdf

Enrollment Options

You have several options for enrolling in Medicare during an SEP:

  1. Online: You can enroll online through the Social Security Administration's website.
  2. In Person: You can visit your local Social Security office to enroll in person.
  3. 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 L564 and CMS 40B 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 coverage depends on when you sign up during your SEP:

  • If you sign up while you have GHP coverage based on current employment, or during the first full month after your coverage ends, your Medicare coverage will begin the first day of the month you sign up.
  • You also have the option to choose to have your coverage start within any of the following three months.
  • If you sign up during any of the remaining seven months of your SEP, your coverage will begin the month after you sign up.
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