What happens if you lose your Employer Group Health Plan when you are eligible for Medicare?

Some people choose to work past their age of eligibility for Medicare. As long as you have coverage with an employer group health plan (EGHP) larger than 20 employees through you or your spouse’s employment, you do not need to enroll in Medicare when you turn 65. Many people in this situation enroll in Medicare Part A and defer Part B until the EGHP ends.

What happens if you suddenly lose your job and employer medical benefits?

Even though your Medicare special enrollment period continues for eight months after losing your EGHP, enrolling in both parts of Medicare should be the first item on your immediate action plan. The enrollment period for enrolling in a new prescription drug plan is only 63 days and is dependent on having at least one part of Medicare. You need both parts of Medicare to complete your coverage with either a Medigap plan or a Medicare Advantage Plan.

Medicare enrollment is facilitated by the Social Security Administration. If you are just adding Part B, Social Security has recently created a special portal on ssa.gov to allow for online Part B enrollment. On the website, look for the “Medicare Enrollment” window and then scroll down to “Apply Online for Medicare Part B During a Special Enrollment Period.” Medicare coverage begins the first of the month after you enroll, unless you specify a different date.

You can also submit your enrollment request during this SEP by doing one of the following:

1. Fax your forms CMS-40B and CMS-L 564 and documentation of EGHP to 1- 833-914- 2016. Forms are available on the SSA website under “Forms”. Send a cover letter with the forms and keep copies of everything.

2. Mail forms CMS-40B and CMS-L564 and documentation of EGHP to your SSA local field office

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1. What is Medicare's Annual Open Enrollment Period?
2. How and when do I enroll in Medicare?
3. How does Medicare work with employer based insurance?
4. Am I covered by Medicare if my spouse or I is employed?
5. When can I switch my Medicare plan?
6. Does Medicare Cover COVID-19 Costs?
7. Do I need Medicare Part D?
8. Does Medicare cover vaccines?
9. What if one or more of my drugs is no longer covered by my Medicare drug plan?
10. What happens if you lose your Employer Group Health Plan when you are eligible for Medicare?
11. What's new for 2023?
12. When are the Medicare General Enrollment Period and the Medicare Advantage Open Enrollment Period?
13. How do I avoid Medicare scams?
14. What are 5-Star plans and when can I enroll?
15. How can I get help paying for Medicare Part B and Part D?
16. What are the different parts of Medicare?
17. How do I update my contact information if I'm moving?
18. Can I change my Medicare Advantage or Medicare Prescription Drug Plan anytime?
19. How do I create a Medicare account?