65 and Laid Off? Here’s How to Enroll in Medicare

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Hello Toni,

Sadly, my husband Steven’s employer laid him off after 20 years. Like many companies in this economy, they’re downsizing. May 31st will be his last day.

Steve is 68 and has Medicare Part A. However, he never enrolled in Medicare B because he had employer benefits. He is stressed and confused about how to apply for Medicare Part B properly to avoid receiving a penalty. I’m also turning 65 in September, so I’ll need to enroll in Medicare.

Please explain our different Medicare enrollment options. We’d appreciate it so much.

Thanks,
Patti from Midland, TX

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Great question, Patti!

There are 2 different rules regarding enrolling in Medicare Parts A and B in your household. Don’t worry. I’ll keep enrolling in Medicare for both you and Steve SIMPLE!

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How to Enroll in Medicare Part B when You’re Past 65 and Leaving Employer Benefits

Steve needs to apply for a Special Enrollment Period (SEP) by completing the following steps:

Download the forms CMS-L564 (Request for Employment Information) and CMS-40 B (Application for Enrollment in Medicare-Part B) from SSA.gov.
Have Steve’s human resources department sign off on the CMS-L564 (Request for Employment Information) form and attach it to CMS-40B.
Under item #9 (Remarks) on the CMS-40B, write what month Part B should begin. (Note: Steve’s start is June 1, 2024.)
File both forms with the local Social Security office. Advise the SS representative that Steve is losing his company benefits and needs his Medicare Part B to begin June 1since his last day of employment is May 31.
Make copies of every document given and received from the SS office.

Medicare enrollment paper with glasses and pen — *^{Image Credit: Shutterstock}*

Patti, your way of enrolling in Medicare is simple and quite different from Steve’s. Go online to www.ssa.gov/medicare/sign-up at least 90 days before turning 65 and apply online for a September 1effective date. It’s truly that easy!

Medicare card, large, with the name John Doe, just an example of a Medicare card — *^{Image Credit: Shutterstock}*

Your “Welcome to Medicare” Kit with your Medicare card will arrive via mail 90 days before you turn 65.

Note: Chapter 1 of Toni’s Medicare Survival Guide Advanced Edition explains in detail how to enroll in Medicare the right way.

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Various Parts of Medicare

What does Original Medicare Part A cover?

There is more covered than just in-patient hospital stays. For instance, if you have surgery, a skilled nursing stay, or need blood, then that is covered under Medicare Part A. Your chronic condition might require home health care or hospice. That is covered under Medicare Part A also.

Here is what is covered under Medicare Part A:

Blood
Home health care
Hospice care
Skilled nursing facility
Most importantly, it covers in-patient hospital stays

What does Original Medicare Part B pay for?

Medical and other services (outpatient surgery, surgeon, doctor visits, anesthesiologist, pathologists, second surgical opinion, etc.).
Clinical laboratory services
Home health care
Durable medical equipment
Blood

Original Medicare or Medicare Advantage

Discuss with your healthcare facilities and medical professionals which Medicare plans they accept such as Original/Traditional Medicare with a Medicare Supplement or a Medicare Part C (Medicare Advantage plan such as HMO, PPO, or PFFS). If you’re considering a Medicare Advantage plan, research the plan’s hospital/provider online directory to be sure your physicians and hospitals are in that specific plan’s network. Verify they are currently in the network.

Medicare Part D (Prescription Drug Plan)

Research the plans every year to see if your stand-alone Prescription Drug or Medicare Advantage Plan with prescription formulary covers all your brand name or generic prescription drugs.

Medicare Part D Drug Tiers

Tier 1 – Preferred generic
Tier 2 – Non-preferred generic
Tier 3 – Preferred brand-name
Tier 4 – Non-preferred brand-name drugs
Tier 5 – Specialty drugs

Long-term Care

Research options such as LTC policies, hybrid annuities or life insurance with LTC riders, new Short Term Care plans, or specific state’s Medicaid rules for long-term care needs.