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

Question

Gary Church · Accepted 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

Voss Speros · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/what-is-cms-l564-form-medicare-enrollment#voss-speros

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

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

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

Casey Ahlbum · 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.

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.

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

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.

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

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?

Agents: Share Your Expertise

Seniors: Ask a Question of Your Own

Agent Locator

Medicare Agents HubA non-government resource website

Medicare Agents Hub
A non-government resource website