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Sample checklist: Tom Alvarez turns 65 in March 2027 and still needs CMS-L564 from his employer. Sample checklist: Tom Alvarez turns 65 in March 2027 and still needs CMS-L564 from his employer.

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The checklist is written. Add your dates and mark your situation.

Then. Keep it next to your forms and mark each one when you send it.

How to sign up for Medicare — your checklist is ready

If you already get Social Security or Railroad Retirement Board benefits, you are usually signed up automatically. If not, you apply through Social Security, online or at a local office. Most people sign up in the 7 months around the month they turn 65. Fill in the checklist below to see your dates and forms.

Updated: · Next check: 2027-02-06

How to sign up for Medicare Opening…
How to sign up for Medicare: first page
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Write your dates first. Everything else follows from them.

Ask your employer for CMS-L564 early, so it is not the last thing you wait for.

Full text of the checklist

Replace what is in square brackets. It is the same text as the Word file.

Download Word (.docx) Free, no sign-up · CC BY 4.0 license

Medicare Sign-Up Checklist

Name: [FULL NAME]
Date of birth: [DATE OF BIRTH]
Filled in on: [DATE]

1. My dates

WhatMy date
Month I turn 65[MONTH AND YEAR]
My Initial Enrollment Period starts, 3 months before that month[MONTH AND YEAR]
It ends, 3 months after that month[MONTH AND YEAR]
Date my work stopped, if I had job-based coverage[DATE]
8 months after that date[DATE]

2. How I sign up

Mark oneMy situationWhat I do
☐I already get Social Security or Railroad Retirement Board benefitsI should be signed up automatically. I watch for my card
☐I do not get those benefits yetI apply through Social Security: online, or at my local office
☐I have Part A and want Part BI send form CMS-40B
☐I am still working, or retired or lost job coverage in the last 8 monthsI send CMS-40B and CMS-L564 together

3. What I have ready

DoneItem
☐My Social Security account, if I apply online
☐CMS-40B, filled in
☐CMS-L564, completed with my employer
☐The date I sent everything: [DATE]

4. Open Enrollment, October 15 to December 7

For changing plans. The plan must get my request by December 7, and coverage starts January 1.

ComparePlan 1Plan 2Plan 3
Plan name[NAME][NAME][NAME]
Monthly premium$[AMOUNT]$[AMOUNT]$[AMOUNT]
Deductible$[AMOUNT]$[AMOUNT]$[AMOUNT]
My drugs covered[YES OR NO][YES OR NO][YES OR NO]
My doctors included[YES OR NO][YES OR NO][YES OR NO]

Deadlines

The rules, with the source

WhatDeadlineSource
Initial Enrollment PeriodStarts 3 months before the month you turn 65 and ends 3 months after itMedicare.gov, When can I sign up
Signed up automaticallyYou turn 65 and started Social Security or Railroad Retirement Board benefits at least 4 months earlierMedicare.gov, How do I sign up
You apply yourselfYou turn 65 and do not get those benefits yet: apply through Social SecurityMedicare.gov, How do I sign up
After job-based coverageGenerally 8 months after you or your spouse stop working. COBRA does not extend thisMedicare.gov, When can I sign up
Part B when you already have Part AForm CMS-40BMedicare.gov, Enrollment forms
Proof of job-based coverageForm CMS-L564, sent together with CMS-40B, if you still work, or retired or lost job coverage in the last 8 monthsMedicare.gov, Enrollment forms
Open EnrollmentOctober 15 to December 7, for joining, switching or dropping Medicare Advantage and drug plans. Coverage starts January 1Medicare.gov, Joining a plan
Puerto Rico or abroadPart A starts automatically, but you sign up for Part B yourselfMedicare.gov, How do I sign up

Open Enrollment is for people who already have Medicare and want to change plans. If you are signing up for the first time, start with your Initial Enrollment Period.

Step by step

What to do, in order

  1. 1

    Write down your dates

    Start with the month you turn 65.

  2. 2

    Find your situation

    Automatic, apply yourself, or Part B only.

  3. 3

    Get your forms

    CMS-40B, and CMS-L564 if you had job coverage.

  4. 4

    Ask your employer

    They complete their part of CMS-L564.

  5. 5

    Sign up

    Online, or at your local Social Security office.

  6. 6

    Compare plans

    Use the sheet in the checklist during Open Enrollment.

Questions

How do I apply for Medicare?

Through Social Security: online at ssa.gov or at your local office. If you or your spouse worked for a railroad, call the Railroad Retirement Board at 1-877-772-5772.

Is December 7 my deadline to sign up for the first time?

Not usually. December 7 ends Open Enrollment, which is for changing plans. Your first sign-up follows your Initial Enrollment Period or your job coverage dates.

I still work at 65. What do I do?

You generally get 8 months after you or your spouse stop working. For Part B you send CMS-40B with CMS-L564, which proves your job-based coverage.

Can I skip Part B?

Part B is optional, but if you do not sign up when you are first eligible, you may pay a late enrollment penalty. Check your own dates on Medicare.gov.

Does this page choose a plan for me?

No. The sheet only helps you write plans side by side. We do not sell insurance and do not call you.

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This is general information and a checklist, not legal or insurance advice. We do not sell insurance or recommend plans.