How to Sign Up for Medicare During a Special Enrollment Period

Take these steps to sign up for Medicare if you’re working past 65

Kimberly Lankford,

AARP

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En español

Published January 28, 2022

/ Updated May 03, 2024

three older adults working with medicare cards

Kotryna Zukauskaite

Even though you can sign up for Medicare during your initial enrollment period around your 65th birthday, you may decide to delay signing up without penalty if you or your spouse still work and you have health insurance through an employer.

You may choose to sign up at 65 for Medicare Part A, which covers hospitalization, because it’s premium-free as long as you or your spouse paid Medicare taxes for at least 10 years.

However, you might delay enrolling in Medicare Part B, which covers doctor and outpatient services and costs $174.70 a month for most people in 2024. High earners pay more. You or your spouse will typically need to work for an employer with 20 or more employees to delay signing up for Medicare without coverage gaps.

How a special enrollment period works

When your job-based insurance ends, you’ll qualify for a Medicare special enrollment period. Sign up before your coverage ends or within eight months of losing the insurance to avoid a late enrollment penalty.

Other coverage decisions: You’ll also need to make decisions about other types of coverage when you enroll in Medicare, including Part D prescription drug coverage and Medicare supplement insurance, better known as Medigap, to help pay Medicare’s deductibles and copayments.

Or you may decide to get a private Medicare Advantage plan that provides health and drug coverage. You must have Medicare Part A and Part B before you can enroll in Medigap or Medicare Advantage.

11 steps to enroll online in Part B during a SEP

The steps to sign up for Medicare Part B during a special enrollment period are different than they are during your initial enrollment period at 65.

If you already signed up for Part A and need to enroll in Part B during a SEP, visit the Social Security Administration (SSA) website and click on Sign up for Part B only | Get started. Scroll down to submit an application | start application.

To complete the form, you’ll need your Medicare number, documentation of your spouse’s or your health insurance, and an email address.

1. At the bottom of the opening page, check a box indicating that you understand the agency’s policies. Click Start application and you’ll be taken to the application page.

2. Scroll down and fill out the enrollment application. Provide your Medicare number, then click Yes when you’re asked if you want to sign up for Part B. Type in your name, address and phone number. In the Remark field, identify the date you would like your Part B coverage to start.

a screenshot of section A of the medicare part b online application with the section “remark” circled in red

3. In Section B, provide information about the employer you’re receiving health insurance from.

a screenshot of section B of the medicare part b online application with the section “employment information” circled in red

4. In Section C, provide information about your group health plan.

a screenshot of section C of the medicare part b online application with the section "for employer group health plans only" circled in red

5. In Section D, you’ll need to provide evidence of your coverage. Complete Section A of form CMS- L564 and ask your employer to complete Section B. The employer can send the form directly to the SSA or send you a digital copy, which you’ll need to upload as part of your application process.

If your employer cannot provide evidence of your group health coverage, you’ll need to submit proof of your employment and health insurance coverage. The following documents are acceptable:

Explanation of benefits statement from your health plan.
Health insurance cards that show the date your policy began.
Pay stubs that indicate your health insurance premiums were deducted.
Receipts or statements that show your health insurance premiums were paid.
Tax returns that show your health insurance premiums were paid.
W-2s that show pretax medical contributions.

If you need to include these documents, upload them in the yellow spaces.

a screenshot of section D of the medicare part b online application with the two section click to attach employment verification fields circled in red

6. Once you’ve completed Section D, type in your name and click Apply.

7. Look for a screen with a black bar at the bottom, then click the blue Click to Sign button.

8. Enter your email address and hit the Click to Sign button.

9. Go to your email account and look for a message from Adobe Sign. Click on Confirm my email address.

10. You’ll be taken to a page that confirms your e-signature was verified. Look for a second email that confirms your submitted application.

11. The SSA will send you a letter informing you of your application’s status. If it’s denied, you can appeal the decision by following the instructions.

Other ways to sign up

If you don’t want to enroll online, print the form and mail it, fax it or bring it to a Social Security office. Alternatively, you can fill out Form CMS-40B and have the employer who provides your health insurance complete Form CMS-L564. If the employer is unable to complete the form, you can submit the documents that show you have health insurance.

To avoid long lines, contact your local office to find out whether you can go in person or must mail your application.

To find your local office, use the Social Security field office locator. If you want to mail your application, use certified mail for delivery confirmation.

New special enrollment periods

On Jan. 1, 2023, the SSA introduced several six-month special enrollment periods for exceptional conditions, such as a natural disaster, misinformation from your employer or losing Medicaid coverage.

You need to submit a different form to enroll in Medicare in these situations. For more information, see Medicare’s exceptional conditions SEP instructions.

How to sign up during a GEP

If you missed signing up for Medicare during your initial enrollment period and any eligible special enrollment periods, you’ll need to enroll during the annual general enrollment period (GEP), which runs from Jan. 1 to March 31 each year. You may have to pay a late enrollment penalty.

If you sign up during this time, your coverage will begin the first of the month after you enroll.

To sign up for Part B, complete Form CMS-40B and send it to your local Social Security office or call for assistance. To find your local office, use the Social Security field office locator. The SSA doesn’t offer an option to enroll online during the GEP.

Special rules for Part A. If you’re eligible for premium-free Part A, you aren’t limited to a SEP or GEP. Contact the SSA at 800-772-1213 to sign up after your initial enrollment period.

If neither you nor your spouse paid Medicare taxes for 40 quarters, you have to pay premiums for Part A and you can enroll only during a SEP or GEP if you missed your initial enrollment period. You may also have to pay a Part A late enrollment penalty. The SSA has no paper form available for enrollment in Part A during the GEP, so you must call.

Images: Social Security Administration (SSA.gov); Centers for Medicare & Medicaid Services

This story, originally published Jan. 28, 2022, was updated with new information.

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Kimberly Lankford is a contributing writer who covers Medicare and personal finance. She wrote about insurance, Medicare, retirement and taxes for more than 20 years at Kiplinger’s Personal Finance and has written for The Washington Post and Boston Globe. She received the personal finance Best in Business award from the Society of American Business Editors and Writers and the New York State Society of CPAs’ excellence in financial journalism award for her guide to Medicare.