Enrolling in Medicare After Age 65: What You Need to Know

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If you delayed Medicare because you were covered through an employer with 20 or more employees, you’re eligible for a Special Enrollment Period (SEP) and can enroll without penalties. Here’s how the process works:

 

✅ Step 1: Have Your Employer Complete Form CMS-L564

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Your employer will need to complete the CMS-L564 “Request for Employment Information” form. This form verifies that you had creditable health coverage through your job, which allows you to enroll in Medicare Part B without a late enrollment penalty.

 

📝 Step 2: Apply for Medicare

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You can apply for Part B (and Part A if not already enrolled) by submitting:

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• CMS-40B (Application for Medicare Part B)
   

• CMS-L564 (Completed by your employer)
   

You have two ways to apply:

• Online: Go to ssa.gov/medicare, complete the application, and upload your CMS-L564 form.
   

• In person: Bring both forms to your local Social Security office.
   

Once processed, your Medicare Part B coverage can begin the first of the month after your employer coverage ends (or another future month if you choose).

 

💡 Step 3: Choose Your Medicare Coverage Path

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Once you’re enrolled in both Part A and Part B, you’ll need to choose how you want to receive your Medicare benefits:

 

OPTION 1: Medicare Advantage (Part C)

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If you’re used to an HMO-style plan, Medicare Advantage might feel familiar.

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• Combines Part A, Part B, and usually Part D drug coverage
   

• Often includes dental, vision, hearing, and wellness perks
   

• Usually low or $0 premium
   

• May require referrals and network restrictions
   

Consider this option if you’re comfortable with limited networks and want lower out-of-pocket costs.

 

OPTION 2: Original Medicare + Supplement + Drug Plan

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If you value broad provider access and minimal restrictions:

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• Keep Original Medicare (Parts A & B)
   

• Add a Medicare Supplement (Medigap) plan to help pay deductibles and co-pays
   

• Add a Part D prescription drug plan
   

This route:

• Offers access to nearly all doctors and hospitals nationwide
   

• Doesn’t require referrals
   

• Has higher monthly premiums and separate coverage for prescriptions
   

• Does not include dental/vision/hearing
   

Consider this option if you’re used to a PPO plan and want the most provider freedom.

 

📄 Step 4: Confirm You Had Creditable Drug Coverage

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After you enroll in a Part D plan or Medicare Advantage plan with drug coverage, your new insurance carrier may request proof that you had creditable drug coverage through your employer.

• This helps you avoid a Part D late enrollment penalty
   

• A form is typically mailed to you within 2 weeks of your plan’s effective date
   

• Complete and return it promptly

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☎️ Step 5: Update Medicare as Your Primary Insurance

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Lastly, since you were previously on an employer plan, Medicare may still be listed as your secondary insurance. When your employer plan ends, Medicare is not automatically notified.

You must call 1-800-MEDICARE (1-800-633-4227) to let them know:

• Your employer coverage has ended, and
   

• Medicare should now be your primary insurance
   

 

📞 We’re Here to Help

If you’re approaching retirement or recently lost employer coverage, let’s talk through your Medicare options. We can help you find the plan that fits your needs and avoid costly mistakes.

Call us at (626) 963-3244 or stop by our Glendora office.