COMING OFF OF GROUP INSURANCE PAST THE AGE OF 65?
YOU WILL NEED TO FILL OUT CREDITABLE COVERAGE FORMS & GIVE THEM TO OUR LOCAL SOCIAL SECURITY OFFICE
Here’s how: Complete two important forms, print them, and submit them to your local Social Security office. Details are below. This confirms you had credible coverage after age 65.
FILL OUT & PRINT THIS PART B FORM
In section 12, “Remarks,” enter the date you want your Part B coverage to start. Medicare Part B always begins on the 1st of the month. Use the form below to request your start date.
FILL OUT & PRINT CMS-L564 FORM BELOW.
Have your employer (typically your HR department) sign it.
THIS INFORMATION IS FOR EDUCATION PURPOSES ONLY
Social Security (ssa.gov) and Medicare.gov are your primary resources for the information you need.
IMPORTANT NOTE:
After signing up for a Medicare plan and submitting the required forms to your local Social Security office, you will receive a letter stating you have a late enrollment penalty. To avoid the penalty, call the number on the letter and inform them that you have already submitted your credible coverage letters to Social Security. This step should have been completed before receiving the letter.
This page is for education purposes only.
If you are confused about what to do as your 65th birthday is coming up, don’t delay! The purpose of this page is to direct you where you need to go to get what you need before your 65th birthday month.