The Social Security Administration’s (SSA) form CMS-L564 is an employment verification form. The purpose of this form is to apply for a Special Enrollment Period (SEP) for Medicare that is outside Initial Enrollment Period (IEP) and the General Enrollment Period (GEP).
Your IEP is seven months long. It begins 3 months before your 65th birthday or the 25th month of your disability and ends 3 months after your 65th birthday, and the GEP is every year from January 1 to March 31
What is the CMS-L564?
This form is called “Request for Employment Information.” This form need to be filled out by the current employer current employer you get your health insurance from, whether it’s yours or your spouse’s. The form asks for your (or your spouse’s) dates of employment and dates of healthcare enrollment.
In addition to the CMS-L564, you also need to fill out the application for Medicare B, form CMS-40B to be granted an SEP. If your employer is unable or unwilling to fill out the form, contact the SSA for other forms of evidence you could provide.
Once the CMS-L564 is filled out, you need to take it to your local Social Security Office.
Can I get a SEP?
In order to be eligible for a SEP, you need to have or be eligible for Medicare due to age or disability, have been in enrolled in an employer group health plan or Medicare Part B for you or your spouse’s current job, and have been continuously covered by that health insurance with a lapse no longer than 8 consecutive months.
If these apply to you, generally, you are granted an SEP. You need to have Medicare Part A to be eligible for Medicare Part B.
What is Medicare Part B? Do I Need It?
Medicare Part B covers your medical expenses, including doctors’ visits, labs and X-rays, medical equipment, preventative services, rehabilitation services, mental health services, and ambulance costs.
It is offered at a low monthly premium, but the premium could be higher if your income is above a certain amount or if you have to pay a late-enrollment penalty. You should sign up for Medicare Part B as soon as you become eligible or when you are no longer covered by another type of healthcare.
If you do have healthcare, you should check with your providers to see how Medicare Part B will work with your current plan.