New Medicare Enrollment Portal (post-65)

We have some exciting news for Medicare Beneficiaries enrolling after age 65 (e.g. coming off of a Group Health Insurance Plan).

In the past, these Beneficiaries had to complete paper/pdf forms and send them (or drop them off) to the Social Security office.  About a month ago, Social Security started providing a fax number that would allow individuals to fax these forms in since the Social Security offices have been closed due to COVID.

Just this week, there is a new enhancement deployed by Social Security that will finally allow these individuals enrolling after age 65 to complete their forms online using an electronic signature.

Below is a snippet from an email that we received from an inside source at SSA/CMS.

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​Effective Tuesday, May 26, 2020, based on the collaborative efforts between the Centers for Medicare & Medicaid Services (CMS) and SSA, the new online process for handling Medicare Part B SEP enrollment will be available online. The online process provides beneficiaries the option to complete the Medicare enrollment forms under an SEP for SSA to process. The online Medicare Part B SEP enrollment link www.ssa.gov/Medicare-PartB-SEP will be available on both SSA and CMS websites effective Tuesday, May 26, 2020. Once the beneficiary completes the online enrollment forms, the forms will automatically transmitted to the SSA Field Office of jurisdiction.
 
Eligibility Overview

As a requirement, regardless of the service channel, in order to enroll for Medicare Part B during an SEP, the following are required:
· The individual must be covered under a group health plan (GHP) based on his or her own or a spouse’s current employment status, or covered under a large group health plan (LGHP), and the coverage must be based on his or her own, or a family member’s current employment status.
· The individual can enroll:
- during any month (including a partial month) in which they are enrolled in a GHP or an LGHP based on current employment status, or
- in any of the 8 consecutive months following the last month, during any part of which, the individual was enrolled in the GHP based on current employment status,
- or beneficiaries are eligible for equitable relief if:
o The beneficiary had an SEP during the period from March 17, 2020, through June 17, 2020; and
o The beneficiary did not apply for Part B during that SEP.
o Eligible beneficiaries who wish to take advantage of the equitable relief must file their enrollment request by June 17, 2020.
· The beneficiary must complete the CMS-40B enrollment form, paper or online to request enrollment. In addition, he or she must complete the CMS-L564 form, paper or online.
· The Form CMS-L564 has two sections:
- Section A - the applicant completes Section A.
- Section B - the employer, the GHP or LGHP completes Section B of the form. The information in Section B provides evidence of GHP or LGHP coverage and dates of employment.

NOTE: If the employer cannot sign the CMS-L564, the beneficiary can provide other evidence of previous employment or coverage of GHP or LGHP, or other documents for evidence of employment. Refer to HI 00805.295 – Evidence of GHP or LGHP Coverage Based on Current Employment Status.
 
Online Enrollment Guidelines

· The online enrollment process will require beneficiaries to complete the CMS-40B, CMS-L564 (one combined online application), and submit any required evidence during one online session.

NOTE: The online enrollment process does not offer beneficiaries the option to save and revisit the application.
· Failure to complete and submit the correct documentation may result in a delay in processing the Medicare enrollment.
· If the beneficiary fails to complete the forms or submit the correct evidence, Field Offices should follow normal business process and develop for the missing information.
During the COVID-19 pandemic, CMS waived the wet signature requirement; however, the online option will require beneficiaries to provide an eSignature (digital signature) and a valid email address.