Today I would like to show you how to begin Medicare coverage if you recently lost your job. We’re here to help you through the process because we know Medicare can be confusing and even a little intimidating. 

If you recently lost your job, keep reading to find out exactly how you can start getting Medicare benefits. 

Qualifying Assumptions

Now before we jump into the topic, let’s address a few quick assumptions we’re making. First up, we’re assuming you’re above the age of 65 and on Medicare Part A. You could be anywhere from 66 to 96. Whatever your age, the main thing here is that you’ve already enrolled into Medicare Part A only, but haven’t enrolled in Medicare Part B. When turning 65, most people enroll in Medicare Part A only because they’re continuing to work. We’re assuming that’s what you did. 

Second, we’re assuming you have no other insurance options. Meaning, you're no longer working your job and you don’t have other employment lined up somewhere else. If you’re married, your spouse is no longer working either, so there are no insurance options available to you besides Medicare. 

When Does Medicare Coverage Start 

Medicare coverage always begins on the first day of any month, never in the middle of the month. So if you’re enrolling this month, your Medicare coverage won’t begin until the first day of next month. 

Enrollment Periods Explained

Medicare allows you to enroll in Medicare coverage at two different times, called enrollment periods. The first enrollment period is called the “Initial Period,” and it’s for people coming into Medicare right when they turn 65. You’re beyond this initial enrollment period, so Medicare has a second enrollment option for you. It’s called a “Special Enrollment Period” or SEP. The SEP is for anyone (like you) who was working at 65 but has now lost employer coverage and needs Medicare benefits. 

How the SEP Works 

The special enrollment period lasts for eight months. This means that once your employer coverage has ended, you have eight months to come into Medicare. While this may sound like good news (and it is), there is a bit of a catch you need to know about. 

Let’s suppose you’ve lost your job and you have no insurance plan. You’re within the eight-month period still, but you haven’t started your medicare coverage yet. Now suppose that during this time you have a large claim. Maybe it’s an unexpected health issue or an accident that requires you to seek medical care. Whatever it is, you need insurance. But you haven’t started Medicare and you have no employer insurance. Now what? 

If you’re still working (I know you’re not, but hear me out) and have employer coverage, the first one to pay the medical bills is the employer’s insurance. They are in the first payor position. If you aren’t working but have started Medicare coverage, Medicare is in the first payor position. However, in our scenario, you are without both employer insurance and Medicare coverage, so guess who’s in that first payor position? You are. 

Now you may be thinking, I have other insurance options, like COBRA, supplemental, or retiree. These secondary options are always in the second payor position. That’s just how it works. So if you don’t have employment insurance or medicare coverage to rely on, you’re the first one paying those medical bills. You don’t want that! 

So once your employer coverage ends, you need to have everything set up so Medicare coverage can start right away. For example, if your employer plan ends June 30th, you need to enroll up to 90 days in advance so you can start Medicare coverage on July 1st. 

How to Enroll in Medicare During the SEP

Now we’re going to show you exactly how to enroll in Medicare during the special enrollment period.

Step 1

First, you have to prove to Medicare you’ve been working and had employer coverage since you turned 65. You’ll prove this to them by having your employer (usually someone from the HR department) fill out a form called the CMS L564. The CMS L564 will have your name, address, and social security number, along with your employer’s name and address, plus verification that you’ve worked with them and had insurance coverage since turning 65. 

If you’ve switched jobs and had multiple employers since turning 65, you’ll need to have each employer fill out a CMS L564 form. Why? Medicare needs to have a record verifying each month of your employment and coverage from the time you turned 65 all the way to the present. 

Once your employers have filled out the form, you’ll send it to your local social security office. You can mail or fax it in, but we recommend delivering it in person so there’s no chance of the form getting lost. You can find the CMS L564 online, or reach out to us here at the Medicare School and we’d be happy to send you a blank CMS L564 form. 

Step 2

Second, you’ll need to let Medicare know which month you wish to start getting Medicare benefits. You’ll do this by once again sending in (or delivering in person) a form to your local social security office. This form is called the CMS 40b, and it’s a pretty simple document. Essentially, all you have to do is fill out which month you’d like to start getting your Medicare benefits. Again, if you need a blank CMS 40b form, we’d be happy to give you one. 

And if you don't know where your local social security office is located, you can use the Social Security office locator on SSA.gov (simply put in your zip code) to find the office nearest you. 

What Happens If You Get Another Job?

So you’ve enrolled in Medicare coverage after losing your job, but what happens if you find another job and go back to work? If your new job has insurance benefits, you’ll want to terminate your Plan B Medicare coverage and go back to the Plan A only coverage. How do you drop Plan B? All you’ll need to do is fill out a very simple form indicating that you want to drop Plan B coverage. You’ll send this form to your local social security office. 

Coverage Options Beyond Plans A & B

We’ve explained how to enroll in basic Medicare coverage if you’ve recently lost your job, however, there are several other insurance products you’ll need to have moving forward. Things like supplemental plans, advantage plans, and prescription drug plans are all necessary to reduce your risks in the future. 

We understand how difficult making the right Medicare decisions can be.  To take the next step, click here to watch our full course or schedule a free one-on-one call with a certified Medicare School Guide who can answer your questions, compare plans options, and even help you enroll. Click here to schedule an appointment.

 

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