Enrolling in Medicare After Your Initial Enrollment Period :: Medicare Part B SEP Process (Special Enrollment Period)

There are two videos further down the page that show you how to complete the required forms to add Medicare Part B. Watching those videos will help greatly!

You will follow one of Four scenarios:

Scenario #1 - you already have Part A, and just need to add Part B

You can submit up to 3 months prior to your requested start date

• Just submit the two required forms (Form 40B and Form L564) to Social Security to add Part B (see Forms to Complete section).

• Follow the instructions further down in the Forms to Complete section and as described in the two videos about Form 40B and Form L564.

• NOTE: SSA guidelines state you can submit this up to 3 months prior to your requested start date…when you’re submitting this while covered on a group health plan based on active employment. However, if you’re doing this in the 8 months after separating from your employer, then Part B must start the month after you submit the paperwork.

  
  

Scenario #2 - you Need Part A & Part B (but NOT Social Security Benefits)

You can submit the online application up to 4 months prior to your requested start date

• First start out with an online application for MEDICARE at www.ssa.gov. [VIDEO: How to Enroll in Medicare Online]. On the application, you will be asked whether you want to enroll in Medicare Part B. Say YES to Part B, and then add in a note in the Remarks section of the application…”I would like my Part B to begin on ______ 1st, 20__”. You will automatically get Part A (which will be backdated up to 6 months from the month you submit the application).

  • Then you will be contacted by a SSA rep via phone or mail requesting the forms Form 40B and Form L564 (see Forms to Complete section). The SSA rep will ask you to either mail or fax the forms directly to Social Security. You can avoid waiting for SSA to contact you by just turning in the additional forms to a local SSA office…but don’t turn them in until you’re within 3 months of your requested start date.

  • Since you don’t have a Medicare # yet…on Form 40B, enter your SSN instead.
    
    
    

Scenario #3 - You Need Medicare & Social Security Benefits

You can submit the online application up to 4 months prior to your requested start date

• First start out with an online application for Social Security RETIREMENT benefits at www.ssa.gov. On the retirement application, you will be asked whether you want to enroll in Medicare Part B. Say YES to Part B, and then add a note in the Remarks section of the application…”I would like my Part B to begin on ______ 1st, 20__”. If you don’t have Part A yet, you will automatically get Part A (which will be backdated up to 6 months from the month you submit the application).

• Then you will be contacted by a SSA rep via phone or mail requesting the Form 40B and Form L564 (see Forms to Complete section). The SSA rep will ask you to either mail or fax the forms directly to Social Security. You can avoid waiting for SSA to contact you by just turning in the additional forms to a local SSA office…but don’t turn them in until you’re within 3 months of your requested start date.

• If you don’t have Part A already…on Form 40B, enter your SSN in place of your Medicare #.

Scenario #4 - you Need Part A & Part B but don’t have 40 quarters paid into Medicare

You can submit up to 3 months prior to your requested start date
This enrollment is done through your spouse’s work record
You need to be married at least 1 year, your spouse needs to be at least age 62, and your spouse needs to have the 40 quarters.

• This enrollment CANNOT be done online. You’ll need to schedule a phone or in-person appointment with Social Security. Call your local SSA office or the main number at 800-772-1213 to schedule. Just know, appointments are often scheduled 1-2 months out, so start calling 3-4 months prior to when you need Part B to start.

• You’ll need to submit Form 40B and Form L564 to SSA (see Forms to Complete section). The SSA rep will instruct you whether to mail, fax, or hand-deliver the forms.

• Follow the instructions below and as described in the two videos about Form 40B and Form L564.

NOTE: As of April 7, 2022...most of the local Social Security offices have re-opened for in-person visits. Anyone with a scheduled appointment, as well as walk-ins, can now utilize these offices again. Some offices are very short-staffed, so services might be limited.

FORMS TO COMPLETE

Application for Medicare Part B (Form 40B) — you complete this

• EACH person enrolling in Medicare Part B needs to complete this form.

• Regardless of how you submit, you must make note of when you want your Part B to start in the Remarks section of the online application or the paper form. For example, “I want my Part B to begin July 1st, 2024”

• If you don’t have a Medicare Number yet, enter your SSN in its place on the form.

• On Form 40B, make sure to match up the dates you enter on #7C with the dates your employer enters in Section B of Form L564 (see that form below).

Request for Employment Information (Form L564) — your employer completes this

• The employer who the existing insurance coverage is through will need to complete this for EACH person enrolling in Medicare after age 65…even the spouse who is enrolling also.

• If you had more than one employer that provided group health insurance since turning 65, then you’ll need one of these forms for EACH employer.

SUBMIT FORMS

ways to submit the paperwork:

Submit In-Person, by Mail, or Fax (Available for All Scenarios)

In this case, you need to submit BOTH the Part B application and Request for Employment Information form to a local Social Security office.

OUR PREFERRED METHOD IS SUBMITTING IN-PERSON

• Be a “Walk-In” at your local SSA office and hand-deliver the forms in-person to a SSA rep - Make a copy first for your records, as sometimes SSA loses paperwork you give them. Most offices are open Monday through Friday from 9:00am to 4:00pm. Have them process the paperwork right there in your presence with a SSA rep at the service window. Typically, the approval will show up online in your SSA account within a few days.
  Try to avoid leaving the paperwork in their drop box, if possible. The drop box route is not very reliable and will lead to much longer processing time.
  
  

• If you mail the forms, make a copy first for your records and then send via USPS Priority Mail, which provides delivery confirmation. Processing time is longer going this route, so only do this if you’re submitting well ahead of time.
  
  

• If you fax the forms, include a cover letter and make note of how many pages are in the fax. Processing time is longer going this route, so only do this if you’re submitting well ahead of time, or if the local SSA office specifically instructed you to do so.

Submit Via Online Upload (only Scenario #1…if you Already have Part A)

You can enter the information from the two forms online. Upload Form L564 at the end for sure. The link where you enter and submit the paperwork is below:

ssa.gov/medicare-partb-sep

Note: Instead of clicking the above link, open a new browser tab and simply type in the URL address to get to the page.

Our video titled “Medicare Part B Online Enrolment (After Age 65)” will show you all the details.

The two forms that need to be completed and submitted to Social Security are:

• Application for Medicare Part B (Form 40B) -- The Part B enrollment is completed through the online application, so you won't need to upload this form (you can if you want, though). Just enter the data and make sure to choose your requested start date in the Remarks section...otherwise Social Security doesn't know when you want it to start.
  
  

• Request for Employment Information (Form L564) -- At the end of the application you need to upload this form (i.e. as a PDF or JPG).
  
  

  E-signature Process -- After you submit the application, you’ll get an email from Social Security with ONE FINAL ACTION ITEM. You MUST click the link in the email that says “Confirm my email address”. Then the application is officially submitted. Reference the image on how this email looks. You will then receive another email from SSA with final confirmation that the application has been submitted…with the opportunity to print and/or save a copy.

(see next section below on how to confirm your application status online)

MEDICARE CARD & PART B CONFIRMATION

Depending on the timing of your request, you should receive a letter in the mail in 2-6 weeks with confirmation that the enrollment has been completed for your requested effective date. And your updated Medicare card will arrive soon after.

You can get confirmation sooner by accessing your Benefit Verification Letter when logged in to your My Social Security online account at www.ssa.gov. Your Medicare Number and start dates will be summarized in the Medicare Information section of this letter. The location of the Benefit Verification Letter is different depending on whether you’re also receiving Social Security benefits.

Your SSA.gov dashboard will look like this…

when you’re receiving BOTH Medicare & Social Security benefits:

when you’re receiving ONLY Medicare (NOT Social Security):

Benefit Verification Letter (example)

Below is an example of the Benefit Verification Letter for someone on Medicare AND Social Security Retirement benefits.

Notice the Medicare Information section shows the Part A (hospital) and Part B (medical) start dates, as well as the Medicare #. See the highlighted spots at the bottom.