What is the CMS-L564 form and when do I need it for Medicare enrollment?

Question

Casey Ahlbum · Accepted Answer

Seniors who are still working and covered by a large group plan can delay starting part B and enroll, without penalty, if they've maintained proof of continuous creditable coverage. 

The CMS-L564 form is used to document creditable coverage, it is signed by a representative of the employer, and is submitted with the application for part B. 

For many seniors, it can make sense to delay starting part B, and the CMS L564 form helps avoid   part B late enrollment penalties by documenting continuous creditable coverage.

Sandra Teel · Answer

If you decide to work past the age of 65, you will need to fill out the L-564 form and submit it to Social Security when you apply for your Part B. The L-564 form is filled out by your employer and shows that you've had "creditable coverage" by your employer since you turned 65. This is a very important document to submit because it will keep you from having to pay a late penalty.

Answered by Sandra Teel on May 4, 2026

Broker Licensed in WV, AZ, CA & 13 other states

Answered by Sandra Teel Medicare Insurance Agent

Terry Salak · Answer

This form is to be filled out and submitted with your Medicare Part B application IF you chose to work, and receive credible medical benefits, through an employer. This form is filled out by your HR department showing that you've had credible coverage past the age of 65 and prevents Medicare/SSA from charging you a late enrollment penalty on your Medicare Part B.

Answered by Terry Salak on May 5, 2026

Agent Licensed in FL, AL, AZ & 11 other states

Answered by Terry Salak Medicare Insurance Agent

Voss Speros · Answer

Voss Speros here, Greek god of Medicare. If Medicare is all Greek to you, you're in luck, I'm Greek.

The question today is, what is the CMS L564 form and when do I need it when enrolling for Medicare?

The CMS L564 form is to prove you had employment coverage. When you're retiring from work, or you're leaving work, or you're dropping your work plan and you're going on Part B, it's after 65. After 65, you missed 65, you put off, postponed your Part B because you're working and using your work insurance. After 65, you're now going to leave work and you need to prove that you had group coverage and you were eligible for that coverage. So when you go on Part B, you don't have to pay penalties. No one wants a Part B penalty because it's up there.

So when you're retiring, you get this form. You get your Part B form, fill that out, and you get this form and submit that, and then you get your employer to sign off saying yes, I had coverage, and boom, you go on Part B, no penalties.

If you have any questions, give us a call. We're more than happy to answer your questions. Thank you.

Jerrid Ehlinger · Answer

Official proof of employer sponsored group health coverage. It is required to qualify for a Medicare Special Enrollment Period (SEP) and avoid late enrollment penalties when delaying Medicare Part B while actively working.

Answered by Jerrid Ehlinger on May 26, 2026

Agent Licensed in MI

Answered by Jerrid Ehlinger Medicare Insurance Agent

Edward MacConnell · Answer

The CMS-L564 is important to show that you had credible employer coverage. This permits you to enroll on Part B at a later date without having to pay a late entrant penalty on your Part B premium

Gary Church · Answer

The CMS-L564 form is an employment document used to verify employment at the time of Medicare enrollment. It is specifically for individuals aged over 65 who need to demonstrate they had credible coverage to avoid a penalty.

Answered by Gary Church on May 5, 2026

Broker Licensed in CA, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent

Sherita Joseph · Answer

It’s the form that proves you had work insurance after 65 so Medicare won’t charge you a penalty when you sign up for Part B later.

Ana V. Magalhaes · Answer

Hi

It’s a form related to coverage through employer and needed to provide to CMS in order to enroll in Part B without paying a penalty fee

Jack Mayer · Answer

It shows proof of Group Employee Health Coverage and you an obtain the form through Medicare.gov or from the SSA in person or online.

What is the CMS-L564 form and when do I need it for Medicare enrollment?

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What is the CMS-L564 form and when do I need it for Medicare enrollment?

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Seniors: Ask a Question of Your Own

Related Questions

Agent Locator

Medicare Agents HubA non-government resource website

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A non-government resource website