UNITED STATES—Toni: My husband is retiring from the company he has worked at since 2005 and now our Medicare nightmare is beginning. Jim’s company has changed ownership since he turned 65 in 2013 and we can only receive verification paperwork which goes back to 2018, leaving a 5-year gap.

Social Security will not approve our Part B to begin January 1 and has stated that we need to come back and apply again any time from January 1 to March 31.

Jim is 73 and I am 70 and the Social Security agent said he would have a 50 percent penalty and I will have a 20 percent penalty. Why is this so complicated? No one in HR will verify because the records only go back to 2018.

What a mess! Please advise what we should do. Jean from Little Rock, AR.

Jean: With companies laying off, changing ownership, or closing the doors, America needs to know the rules of Medicare. Not all HR departments are aware that employees past 65 need to have the Social Security form CMS-L564 known as Request for Employment Information which verifies proof of group health care coverage based on current or past employment. This form should be completed and signed by the employers HR department. This information should be part of the new employee and current employees and their spouse’s paperwork who remain on employer group health insurance plan when a company is sold.

Have the CMS-L564 form signed by the old employers when you are past 65 and retain it in a safe place for when you finally retire past 65 and need to apply for Medicare Part B for both yourself and your spouse (if they are also receiving benefits from your company).

Last week, a new client came to the Toni Says office for Medicare consultation. Since he reads the Toni Says column in his area newspaper, he was aware to go back to his past employers (which there were 3 since he turned 65) and have each employer fill out the CMS-L564 form.

He specifically made sure that there was not a gap between these employers. When he retires next year, he will have his current employer also fill out a form and take all forms to his local Social Security office.

Jean, I would speak with the HR manager and express your concerns. If these forms have any gaps, then both of you will receive a Part B penalty. You must enroll during the General Enrollment Period which the Social Security agent said was from January 1 to March 31.

Medicare Special and General Enrollment Periods listed below:

  • Special Enrollment Period: Enroll after 65 when delaying Medicare Part B for you and your spouse due to working full time with company benefits. All employers since turning 65 need to sign CMS-L564 form.
  • General Enrollment Period: January 1-March 31 is the enrollment period when one who has not enrolled in Part B or cannot receive all employer benefit verification dates from current and/or past employers on the CMS-L564 “Request for Employment Information” form since turning 65. During the General Enrollment Period, one can enroll in Medicare Part B, but WILL receive a Part B penalty for each 12-month period that you cannot prove you had employer benefits. The Part B penalty will be for each month you are using Medicare. Your Medicare Part B will begin July 1.

For a Medicare Checkup, call the Toni Says® Medicare call center at 832-519-8664 or email info@tonisays.com regarding your Medicare plans and options.

Medicare Open Enrollment Special: $10 discount to the Toni Says® readers on the 2021Medicare Survival Guide® Advanced book at www.tonisays.com.