These forms are
required when were coming in at a later date.
So this is someone that's at least 65
and four months old and beyond 66, 67, 72.
And so I want to explain to you exactly
how to fill out these forms properly.
Welcome to Medicare School Daily where we help
you understand Medicare, save money,
avoid making mistakes, and above all else,
get the most out of your Medicare benefits.
Now, today's topic actually
are dealing with some forms how to fill those forms out.
Those forms are called the CMSL564 and the CMS40B
Now, these forms have to do with enrolling into Medicare.
Now, as I get into this, I just want to remind you
that when we start Medicare,
there's actually two different times
which we can start our Medicare benefits.
We can start those benefits
right at 65 our 65th birth month,
or we can start at a later date.
Now, that means that someone is at least
65 and three months old and beyond.
They may be 66 or 67 or 72, but they're coming in later.
So when we come into Medicare at 65,
that's called the initial enrollment period.
If we come in later
and the reason we would do that is because you or
your spouse are still working
covered by an active Employer-Provided plan,
and you believe that that plan option is better
than your Medicare option Okay.
And so we're going to address,
first of all, the initial enrollment period,
and that is simply when someone starts at 65
and they have seven months to enroll in the Medicare,
that's three months before they turn 65, the month
they turn 65, and then three months after.
And the month that you enroll will determine
when they start your coverage.
And so that means
if I enroll April, May or June,
they start my coverage in July.
If I enroll in July, they start me in August.
If I enroll in August, they start in October,
I enroll in September,
they skip October, skip November, I start in December.
If I enroll in October, they skip
November, December, I start in January.
So you kind of see if I start enrolling
during these last four months, they delay my coverage.
I enroll the first three months,
I start my birth month.
That's called the initial enrollment period.
And here's what I want you to know.
The L564 and the CMS-40B
notice are not required when you come into Medicare
at 65 during the initial enrollment period.
These forms are required
when we're coming in at a later date.
So this is someone that's at least 65
and four months old and beyond 66, 67, 72.
And so I want to explain to you
exactly how to fill out these forms properly.
So here is the L 564 form, and this is what is called
the request for employment information.
Now, keep in mind,
this means we're coming into Medicare
after 65 and for months you or your spouse were working.
Okay.
And so let's just say that it's
the husband is still working wife's already retired
but is on the husband's plan at work.
And so what would happen employers name
obviously the company
you work for their address of course city state and zip.
Now there's
two lines here for applicants name and employee's name
so let's say it is the husband that's working
and they would be.
And both of them are going to need this form
the husband would be applicant and employee.
But for the wife
who's not working there but covered by the group plan,
it would be
the wife's name here and the husband's name there.
And then, of course, the respective
Social Security numbers.
And so you are responsible for Section eight.
Now, again, if you work with us, we
are happy to do this for you. We do this all the time.
It will certainly be done correctly.
Now, let's talk about the next section
which your employer is going to fill out.
This is important
because you have to make sure that they do it correctly.
Now, it says here is or was the applicant
covered under an employer group plant.
Well, obviously, we're filling this format.
So the answer to that question is yes.
If they weren't, then we have some type of a problem.
But if it is, yes, which it should be,
then they just want to know, when did that coverage begin?
Now, keep in mind,
let's suppose you're starting Medicare at 69.
We have to prove that you've had credible coverage
with these kind of forms all the way back to 65.
Now, if you've been with the employer
from 69 all the way back to 65,
we only have to have one of these forms.
But if you have changed jobs after 65 and you are covered
or covered by a different employer plan
during that period of time,
then we would actually need to have two of these forms.
All right, because we have to prove
a very critical coverage all the way back to 65.
So if you gives the date that the coverage began,
has the coverage ended now maybe or maybe not
most people were doing this before they retire
and that that is typically going to say no.
But if it says yes, that is no problem.
As long as we are doing come into Medicare
no more than eight months after that Employer-Provided
coverage began because if we try to come in
eight months, we're going to have problems.
So it's eight months after employer coverage began
that we have to
take this action within that eight month
window.
Now, again, we usually are doing this before you retire.
You've set the retirement date.
So we're taking care of all this in advance.
But if we're doing it later, the longest we can go
is eight months after employer coverage began.
That's the significance of that question.
And it says, if you give the date, the coverage ended.
And so, again,
that's that eight month window that we have.
All right, then number five,
when do the employer work for your company?
So this is a time of employment.
Usually we're doing this.
Why you're still working so they will put in a date
here, still employed.
Now, it says here, if you're a large group
health plan and the applicant is disabled,
again, that is very rare. And Number
Six is done
so most of the times
we're just addressing questions
one to five and then for hours banked again, very, very rare.
That's even filled out.
I think I've done it
maybe two or three times in my whole career.
And then for all employers, notice what it says.
We have to have the signature of
the person who filled the form out
and course what their title is could be H.R.
department.
It could be vice president of of you know,
how the company or whatever it doesn't matter
just they have to sign it and official
and then of course their date and their phone number.
All right so let's review again you have to do part A
or we'll do it for you.
Employer is going to fill out part B
and then the employee is going to have to sign a date this.
Now this form can be faxed in and faxed back to you.
We do not have to have a
what we call a wet signature on the form
just as long as it's been
completed, promptly signed and dated.
That's all we need.
Now, know the things important about
the fourth is that we never
want this form to be the date of this form.
And signature date and filled out
date to be any
more than 90 days prior
to when we're going to begin coverage.
So we have to do this
within the 90 day window so you don't get this
filled out six months or a year in advance.
It's not going to work that way.
We have to have this form
filled out within a 90 day window
of when we're going to submit the form
and start our Medicare benefits. All right.
So that's the L564 now, Let me explain.
Secondly, real quickly,
the CMS 40B, it's a very simple form,
and let me explain how to how to fill that format.
Now, the CMS 40 B form is not filled out by your employer.
It's filled out by you or by us if we work with you.
And but I do want to go to the details
because there's a couple of things here
that are very important.
Number one, it says your Medicare number.
Now, again,
you're starting Medicare now at know 66 or 67 or 72.
And so you may have already enrolled into Medicare A only.
And if you did that, you have a Medicare A only card.
But if you didn't enroll into Medicare,
which was really not necessary,
if you're a continue to work
and you're covered by a group plan of 20 or more,
you don't have to do anything with Medicare at all.
And so if you have not done the Medicare A,
then what you can put in here instead
you just simply put in your Social Security number.
If so, if you know the Medicare number,
we put it there.
If not,
we just put Social Security number there
and then it says, do you wish to sign up for Medicare B?
Well, that's obvious because that's
what we're doing with this form.
We are signing up for Medicare,
B, so we're going acknowledge that.
And then, of course, you put your name.
And remember, they do want last name,
first name, middle
initial or middle
name on that line and then your mailing address
and and then the city street,
of course, and then your zip code,
you'll put your phone number down.
That's the most easy to reach you.
It is rare that they call you, but just in case
something ought to go wrong, they may reach out to you.
So you have a phone number
and then it says here a signature. And that of course,
sign your name and put the date here.
Now this does throw some people off. It says on here
there's a signature of a witness,
an address of witness.
Now, 99.9% of all people would never have to fill that out
because this is a witness for someone that didn't
know how to sign their name.
That means they sign their name within X.
I think those days are pretty much gone.
But if someone does sign with an X,
then there will be a witness signature required.
Otherwise you just simply sign your name.
You can skip nine and ten.
And here's the most important part of this document
is number 12. The remarks section.
And what we're going to do here
is we're going to tell the Social Security office
when we want to start our Medicare benefits.
And so let's say you're working
and your group plan is going to end June 30th.
Then we're going to put on here,
please begin my Medicare benefits
July one of whatever you're going to start.
So we actually tell them the date we want to begin our
Medicare benefits,
because if you don't put the date in there,
they're going to start you
the very next month from when they get this form.
Well, you may want to submit this
60 days or 90 days in advance.
You're prepared and try to get all this set up
well in advance. So we have to pick the date.
Now, keep in mind, just like I was
saying on the L564, we don't want anything
submitted prior to 90 days of our coverage.
We don't want these things completed
any sooner than 90 days because then
those dates have expired.
And so they like things to be current within 90 days
when we want our Medicare benefits to begin.
All right, so that's the L564
and the 40 B form
that are required
if we're going to come into Medicare using
the special enrollment period,
which means we're at least 65 and four months and beyond.
And now we're ready to start our Medicare benefits
Hey, thanks so much for watching the video,
and I do hope that it was helpful.
Now if you feel like
you need to learn more about Medicare
to make sure you're making the right Medicare decision,
really the best way and the easiest way to do
that is to go to MedicareSchool.com.
That's MedicareSchool.com,
and you'll be given the opportunity to be able
to click on Get the Free Workshop.
We call that the essentials workshop
and I do all the teaching.
And there you'll learn all the ins and outs of Medicare
to make sure that you have an accurate
and thorough understanding of how Medicare works.
The second thing you can do
is click where it says, talk to a Medicare guide,
and there
you can actually set up a time
where you can discuss your situation
with a Medicare guide.
They'll explain all your options
and actually even walk you
through the enrollment process as well,
if that's what you need to do.
And so go to MedicareSchool.com,
watch the workshop or talk to a Medicare guide.
It would be our privilege to assist you further.