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Enrolling in Medicare During the Coronavirus Emergency

Update 4/14/20: SSA updated its coronavirus guidance page to reflect new Medicare enrollment information. Relevant changes have been made below. 

Original Post 4/9/20: During the public health emergency caused by the coronavirus, Social Security Administration (SSA) offices across the country closed their physical doors and moved all operations to online and telephone platforms. SSA created a new resource page to keep the public updated and explain how to access services amid the office closures. Anything affecting access to SSA has an impact on people applying for Medicare coverage, as SSA is the agency that handles enrollment. Importantly, Medicare enrollment continues, though people may encounter some delays.

As always, people who become eligible for Medicare, and who are already receiving either retirement or disability benefits through Social Security or Railroad Board Retirement benefits, are automatically enrolled in Medicare and do not have to contact SSA.

Those who do not fall into one of those categories may need to actively enroll. SSA notes that people who are applying for the first time can do so using an online application. Recognizing that some people may not be comfortable with an online process or may not have access to a computer, SSA also allows people to enroll by calling the toll-free number at 1-800-772-1213 from 7 AM to 7 PM Monday through Friday. For people who are deaf or hard of hearing, call the TTY number at 1-800-325-0778.

For others, enrolling by mail may be the best option. SSA notes that if someone already has Medicare Part A (hospital coverage) and wants to add Part B (outpatient coverage), they cannot do so online. Instead, these individuals need to sign up by mailing form CMS-40B to their local SSA office.

People applying for Medicare Part B due to a loss of employment-based group health coverage will also need to complete form CMS 40-B (Application for Enrollment in Medicare Part B) along with form CMS-L564 (Request for Employment Information) and submit proof of employment, Group Health Plan (GHP), or Large Group Health Plan (LGHP) coverage. SSA recently updated its information page to indicate that applicants should return the completed forms to their Social Security office by mail or by fax to 1-833-914-2016.

Due to coronavirus-related office closures, stay-at-home orders, and other disruptions, some beneficiaries are experiencing difficulties completing form CMS-L564, as it requires employer input. In such instances, SSA is allowing beneficiaries to fill out the employer portion of the form themselves and submit additional documentation as proof of employment. Acceptable forms of secondary evidence include:  

  • income tax form that shows health insurance premiums paid; 
  • W-2s reflecting pre-tax medical contributions; 
  • pay stubs that reflect health insurance premium deductions; 
  • health insurance cards with a policy effective date; 
  • explanations of benefits paid by the GHP or LGHP; or 
  • statements or receipts that reflect payment of health insurance premiums. 

SSA advises people with additional enrollment questions to contact them directly. Medicare Rights recommends that beneficiaries take down the names of any SSA representatives they speak to, along with the time and date of the conversation. Additionally, any paperwork should be submitted through certified mail. Local SSA office contact information, including mailing address and phone number, is available through the Social Security Office Locator.

Notably, it may take SSA up to 21 days to process Medicare applications. When someone’s coverage begins depends on when they sign up. For people who are using the Part B Special Enrollment Period (SEP), coverage will be effective the first day of the month after SSA receives their application. Those who enrolled earlier this year during the General Enrollment Period (GEP) will have coverage beginning July 1. If someone enrolls during their Initial Enrollment Period (IEP), they may also have to wait for coverage.

Because of disruptions caused by the coronavirus public health emergency it’s possible that SSA application processing may be take longer than anticipated. If you run into problems, do not give up. Continue to contact SSA and call our National Helpline at 800-333-4114 for assistance. Also consider contacting your federal elected officials if you experience issues or delays.

Read more about SSA changes during the coronavirus public health emergency.

Read more about Medicare eligibility, enrollment, and coverage.

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