Alyssa Lane
Medicare Part B is medical insurance. To sign up for Medicare Part B, you need to contact the Social Security Administration. You can apply online, which is the easiest and fastest way to sign up. If you already have Part A, you can apply online for Part B. If you have an employer, they need to fill out form CMS-L564. If your employer cannot fill out the form, you can complete Section B of the CMS-L564 form, but you do not need to sign it. You can also fill out form CMS-40B and send the completed form to your local Social Security office by fax or mail. If you have a special situation, you need to fill out the Application for Medicare Part A and B — Special Enrollment Period (Exceptional Conditions) (CMS-10797).
| Characteristics | Values |
|---|---|
| Who is eligible for Medicare Part B | Individuals living in Puerto Rico or outside the U.S. |
| Who gets Part A automatically | Individuals living in Puerto Rico or outside the U.S. |
| Who needs to sign up for Part B | Individuals who want Part B |
| When to sign up for Part B | Within 3 months of turning 65 |
| Penalty for late enrollment | Monthly late enrollment penalty |
| How to sign up for Part B | Contact SSA or apply online |
| Form to fill out for Part B | CMS-40B |
| Form to fill out for Special Enrollment Period | CMS-10797 |
| Form to fill out for Request for Employment Information | CMS-L564 |
| Form to fill out for Application for Medicare Part A and B | CMS-18-F-5 |
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What You'll Learn
Applying for Medicare Part B if you live in Puerto Rico or outside the US
If you are a resident of Puerto Rico or live outside the United States, you are eligible for Medicare Part A (Hospital Insurance) without having to sign up for it. However, if you wish to enrol in Medicare Part B (Medical Insurance), you must actively sign up for it.
To enrol in Medicare Part B, you must contact the Social Security Administration (SSA) to determine the best way to sign up based on your situation. You can find and fill out the CMS-40B form online through the Social Security website or the Centers for Medicare & Medicaid Services website. Alternatively, you can visit your local Social Security office to sign up.
It is important to enrol in Medicare Part B as soon as you are eligible. If you do not sign up for Part B within 3 months of turning 65 or within 3 months after your Part A starts, you might have to wait to sign up and pay a monthly late enrolment penalty.
If you are outside the US, you may want to consider enrolling in Part B if you plan to return to the US to receive healthcare services. It is important to note that your Medicare coverage outside of the US is limited to emergencies, and even then, there is a lifetime limit. If you are within six hours of an American port, your Medicare coverage is applicable, including while you are at sea.
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Applying online for Part B
To apply online for Medicare Part B, you must meet certain eligibility criteria and follow specific procedures. Here is a step-by-step guide to help you through the process:
Eligibility:
Before applying for Medicare Part B, it is important to understand the eligibility requirements. Most people are eligible for Medicare when they turn 65, but younger people with disabilities or permanent kidney failure may also qualify. Additionally, if you have been covered by an employer group health plan after turning 65, you may be able to enroll in Part B without penalty during a Special Enrollment Period. This period typically lasts for 6-7 months, starting from when your employer group coverage ends.
Prepare the required documentation:
To complete the enrollment process, you will need to gather certain documents. This includes proof of your age, citizenship or residency status, and work history. If you are enrolling due to a disability or permanent kidney failure, you will need additional documentation to verify your condition.
Create a secure Medicare account:
Go to Medicare.gov to create your secure Medicare account. You will need your Medicare Number, which can be found on your Medicare card. If you live outside the U.S. and don't have a Medicare card, you can still create an account by providing the necessary identification and residency information.
Complete the online application:
Log in to your Medicare account and navigate to the enrollment section. Carefully fill out the application form for Part B, ensuring that all the information is accurate and up to date. You may be asked about your current health coverage, expected future coverage, and other relevant details.
Submit the application and wait for processing:
After completing the online application, submit it and wait for a response from Medicare. The processing time can vary, but you should receive a notification regarding your enrollment status. If you have any questions or concerns during the process, you can contact the Social Security Administration (SSA) for assistance. They can guide you through the enrollment process and answer any specific questions related to your situation.
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Applying for Part B during the Special Enrollment Period
If you are applying for Medicare Part B during the Special Enrollment Period (SEP), there are a few things you need to know and some specific steps you need to take. Firstly, it's important to understand that the Special Enrollment Period is only available for a limited time and if you don't sign up during this period, you'll have to wait for the next General Enrollment Period, which may result in a monthly late enrollment penalty.
Now, let's go through the steps for applying for Part B during the SEP:
- Fill out the necessary forms: The forms you need to complete depend on your specific situation. If you are applying for the SEP due to exceptional conditions, you need to fill out the CMS-10797 form. If you are applying for the SEP for the working-aged and working disabled, you need to complete the CMS-L564 form, along with the applicable Part B enrollment form (CMS-40B). If you have Part A and want to add Part B during the SEP, you only need to complete the CMS-40B form. Make sure to submit any required proof of job-based health insurance along with your forms.
- Submit your forms: Once you have completed the necessary forms, you need to submit them to your local Social Security office. You can send the completed forms by fax or mail.
- Provide documentation: If you are applying for the SEP, you must demonstrate, through documentation or written attestation, that circumstances beyond your control caused you to miss the initial enrollment period. SSA will determine the start of your SEP on a case-by-case basis, but it will last for at least six months.
- Understand the timing of your coverage: If you enroll during the SEP, your Medicare benefits will typically start the month after your enrollment. However, if you are eligible for the SEP due to a termination of Medicaid eligibility, you may elect an earlier start date for your Medicare benefits, but you will need to pay all prior premiums.
Remember, the Special Enrollment Period for Medicare Part B is designed for specific situations, such as having had employer-based coverage or qualifying for exceptional conditions. Make sure to review the eligibility criteria carefully and provide the necessary documentation to ensure a smooth enrollment process.
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Filling out the CMS-L564 form
To fill out the CMS-L564 form, you need to complete Section A, and your employer needs to complete Section B. This form is used to request employment information and is required when enrolling in Medicare Part B during a Special Enrollment Period (SEP). Here's a detailed guide on filling out the CMS-L564 form:
Section A (To be completed by the applicant)
In the first section of the form, you need to provide the following information:
- Your name and address, or the name and address of your spouse if they are the ones who provided your previous health insurance.
- Your Social Security Number (SSN) or your spouse's SSN, if their health insurance covered you.
Section B (To be completed by the employer)
The second section of the form is to be filled out by your employer. This section requests information about your employment and health coverage through your employer. Here are the key points to be completed by the employer:
- Employer's name and date: Write the name of your employer and the date you're filling out the form.
- Hours bank arrangement: Check yes or no if the applicant was covered under an hours bank arrangement. If no, complete the section for "Employer Group Health Plans ONLY".
- Health coverage and reserve hours: Indicate if the applicant currently has health coverage and provide the date when the remaining hours in the employee's hours bank account expired or will expire.
- Signature and title of a company official: An official representative of the company needs to sign and print their title in the designated fields.
Once both sections are completed, you can submit the CMS-L564 form along with your Application for Enrollment in Medicare (CMS-40B) to your local Social Security office.
Please note that the CMS-L564 form is only required if you are enrolling in Medicare Part B during a Special Enrollment Period. If you are enrolling during the regular enrollment period, you may not need to submit this form.
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Signing up for Part B when you turn 65
Signing up for Medicare Part B when you turn 65 is a straightforward process, but there are a few things you need to keep in mind. Firstly, it's important to understand the eligibility requirements and enrolment periods for Part B. You are eligible to sign up for Part B starting three months before you turn 65 and ending three months after you turn 65. This is known as the Initial Enrollment Period (IEP) and it lasts for seven months in total.
During this IEP, you can sign up for Part B without incurring any penalties or gaps in coverage. However, if you miss this initial enrolment window, you will have to wait to sign up, and you may have to go without coverage for a period of time. Additionally, you might also be subject to a monthly late enrolment penalty for as long as you have Part B. This penalty increases the longer you wait to sign up.
If you or your spouse are still working when you turn 65, you may be able to delay signing up for Part B without incurring a late enrolment penalty. This is because your employer's group health insurance may provide primary coverage. However, it is important to check with your employer to see if you need to sign up for Part B when you turn 65, as some insurance companies may reduce their payments or deny coverage if you are eligible for Medicare.
If you do decide to delay signing up for Part B, there are Special Enrollment Periods (SEPs) that may apply to you. For example, if you have group health insurance through your job or your spouse's job, you can sign up at any time while still covered by the group health plan. You can also sign up within eight months of losing your group health coverage or within eight months of leaving your job, even if the group health plan continues temporarily. These SEPs help to ensure that you have continuous coverage and avoid penalties.
To sign up for Part B, you will need to contact the Social Security Administration (SSA) and fill out the necessary forms, such as the CMS-40B form. You may also need to provide proof of your job-based health insurance. It is recommended to sign up for Medicare Part B about a month before your current coverage ends to avoid any gaps in your healthcare coverage.
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Frequently asked questions
Individuals who live in Puerto Rico or outside the U.S. are eligible for Medicare Part B.
If you are ending an employer group health plan, you can apply online during the Special Enrollment Period. Alternatively, you can contact SSA to determine the best way to sign up based on your situation.
If you are eligible for Medicare Part B, you must sign up within 3 months of turning 65. If you do not sign up during this period, you may have to wait and pay a monthly late enrollment penalty.
You will need to fill out the Application for Enrollment in Medicare Part B (CMS-40B) form. If you are applying during the Special Enrollment Period, you will also need to fill out the Request for Employment Information (CMS-L564) form.
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