What is Form CMS-L564 and what is it used for?
The short answer
Form CMS-L564 is a form your employer completes to confirm you had employer-sponsored group health coverage. You use it when enrolling in Medicare Part B outside your Initial Enrollment Period to avoid a late penalty.
The full explanation
When most people turn 65, they have a limited window to sign up for Medicare Part B, the part that covers doctor visits and outpatient care. If you miss that window, you can face a permanent late enrollment penalty added to your premium.However, there is an exception. If you delayed Part B because you were covered by a group health plan through your own active employment or a spouse's active employment, you are entitled to a Special Enrollment Period. This lets you sign up for Part B without a penalty after that coverage ends.To use that Special Enrollment Period, Social Security needs proof that your delay was for a legitimate reason. That's where Form CMS-L564 comes in. Your employer fills out this form to confirm that you had employer-sponsored group health coverage and for what period. You submit it along with your Part B enrollment application, typically Form CMS-40B.A few things worth knowing: the coverage must be based on current, active employment, not retiree coverage or COBRA. Retiree insurance and COBRA do not qualify you for this exception. If your employer no longer exists or is unable to complete the form, there are alternate ways to document your coverage, but you should contact Social Security directly to work through that.
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