Leaving Employer’s Benefits Past 65 is Puzzling!

Hi Shirley,

The Social Security representative gave you excellent advice about your husband’s Medicare. I’ve written about the famous form to verify employer benefits for those enrolling in Medicare past 65. The for,m is called CMS L-564 “Request for Employment Information.”

Someone who works in the Human Resources department will have to fill out and sign the form. Your husband will also have to fill out the CMS-40B form “Application for Enrollment in Medicare Part B.” Under #12 Remarks of CMS-40B state which month Jay wants his Medicare Part B to start. Across the top of each form, write “Special Enrollment Period” to claim the Medicare enrollment period he wants to enroll in. This will prevent him from receiving the dreaded Part B penalty!

How to Avoid the DREADED Medicare Part B Penalty!

As Shirley discovered, avoiding a Medicare Part B penalty is stressful. A reader whose wife is retiring recently visited the Toni Says office for a Medicare consultation. The husband, 72, has had Medicare Parts A and B since he turned 65 in 2018.

The wife qualified for the Medicare Supplement Open Enrollment (6-month enrollment period). Because her Medicare Parts A and B began in February 2024, she can pick whichever Medicare Supplement plan she desires without having to answer one health question. 

However, the couple is experiencing the pain and agony of trying to enroll the husband in a Medicare Supplement plain. He is currently on both spousal company benefits and Medicare Parts A and B. Unfortunately, since he’s been enrolled in Medicare since 2018, he can only apply for a “guaranteed issue” Plan F not Plan G Medicare Supplement policy. This gentleman has heart and cancer issues that keep him from qualifying medically.

Bottom Line

To avoid answering health questions, you must have a “current” company benefit termination letter to prove to the Medicare Supplement insurance company that you’re in a “guaranteed issue” period. If you don’t have a current termination letter and you have health issues, then you won’t qualify medically due to those issues. You’ll then have to choose either Original Medicare without a Medicare Supplement to pick up Medicare’s out-of-pocket or a Medicare Advantage Plan HMO or PPO.  

Fortunately, I’ve written about this special 6-month window many times and have stressed the importance of enrolling in Part B at the correct time and the correct way. If you leave employer benefits and decide to enroll in a Medicare Advantage plan, verify that your medical providers are in the network for the Medicare Advantage plan you are interested in. Always check and double-check when it comes to Medicare!

Important Medicare Enrollment Situations

A Working Spouse

If the working spouse is providing health insurance benefits from their current employment group health coverage, then you may want to delay enrolling in Medicare Part B. You may continue to work either part-time or as a self-employed individual while taking advantage of the coverage provided by your working spouse. 

Self-Employed

If you’re turning 65, are not covered under an employer’s group health plan, and waited to enroll in Medicare Part B, then you can receive a 10% penalty for every 12 months that you were not enrolled in Part B when turning 65.

Past 65 and Still Employed

Verify with your (or your spouse’s) employer’s HR department if you should delay enrolling in Part B because you (or your spouse) are “still working” and are on an employer group health plan. As soon as you will are no longer covered by an employer group health plan, have the HR department fill out and sign Social Security form CMS-L564 “Request for Employment Information” and you fill out and sign, CMS-40B “Application for Medicare Part B. Contact your local Social Security office to file both forms to justify your delay in enrollment in Medicare and avoid needless penalties.

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