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Medicare Enrollment Guidelines
If you are retiring soon and are eligible for Medicare Part A and B due to age or disability, it is important that you (and your spouse, if they are Medicare eligible) start the application process for Medicare
Part A and Part B 90 days prior to your retirement date.
If you already have Medicare Part A and wish to sign up for Medicare Part B, you must submit the two required forms listed below, (CMS 40B and CMS L-564).
You have three options to submit your enrollment request under the Special Enrollment.
- Go to Apply Online for Medicare Part B During a Special Enrollment Period and complete CMS-40B and CMS-L564. If you have Form CMS-L563 already completed by your retirement counselor, you can upload it here.
- Fax your CMS-40B and CMS-L564 forms to 1-833-914-2016.
- Mail your CMS-40B, CMS-L564, to your local Social Security field office.
Note When completing the CMS-L564
- State on the form “I want Part B coverage to begin (MM/YY)”
- Yale retirement counselor will complete section B and provide the form to you to submit to the Social Security office.
If you are enrolling in both Medicare Part A and Part B, you must call Social Security at 1-800-772-1213 to begin the Medicare application process.
You can find the address to your local office using the Social Security Office Locator. You can also call the Social Security Office at 1-800-772-1213.
- Form CMS 40B. - This form is to be completed by the retiree and/or spouse if they already have Medicare Part A and are only enrolling in Medicare Part B. CMS Website.
- Form CMS L 564. - This form is required if you are enrolling Medicare Part A or B, or both. It should be completed by a Yale retirement counselor. If you have not met with a Yale retirement counselor, please contact Yale Employee Services at 203-432-5552. CMS Website.
It is important to mail or fax these forms to your local Social Security Office in a timely manner (90 days prior to your Medicare Part B effective date). Please make a copy of both forms for your records.
When you, or your spouse, have received confirmation of your Medicare Part B enrollment, you should contact the Aetna Retiree Service Center at 800-338-4533 to enroll in your retiree health plan.