Medicare and other health coverage coordination
Coordinates Medicare timing, payer order, and drug coverage across current-employer plans, COBRA, retiree coverage, ACA Marketplace coverage, VA health care, and TRICARE.
A directory listing, not an eligibility decision.
UniHealth can identify a possible match, but the responsible program makes the final decision.
What to know
- Why it may fit
- Your circumstances can be checked against the program’s published guidelines.
- What to do next
- The rules for when to sign up for Medicare if you have other coverage. This includes job, retiree, COBRA, Covered California, VA, or TRICARE coverage.
- Who runs it
- Social Security / CMS
What the program may consider
- Medicare entitlement or upcoming age-65 window
- Current-employer, retiree, COBRA, Marketplace, VA, TRICARE, or other coverage
- Eight-month Part B Special Enrollment Period when active-employment coverage ends
- Entitlement reason, ESRD coordination period, employer size, and coverage type determine who generally pays first
- Creditable drug coverage and Part D timing across each kind of coverage you have
How to get it
The rules for when to sign up for Medicare if you have other coverage. This includes job, retiree, COBRA, Covered California, VA, or TRICARE coverage.
How to apply
Sign up for Medicare Part A and Part B
Social Security handles Medicare sign-up. People who already get Social Security are signed up on their own.
The same application can also ask for Original Medicare.
- OnlineSocial Security website
- PhoneSocial Security: 1-800-772-1213TTY 1-800-325-0778
- In personYour local Social Security officeUse the office finder for the address and hours.
- Phone1-800-MEDICARE: 1-800-633-4227
- PhoneHICAP free Medicare counseling: 1-800-434-0222Free, unbiased help with Medicare choices.
- PhoneSourcewise information line: (408) 350-3200Weekdays, 8 a.m. to 5 p.m. Ask for the program you need.
- Online formSourcewise HICAP counseling requestAsk for yourself or for someone else.
- In personHICAP counseling sitesSenior centers, libraries and community centers. Call the site or book online.
Getting help
Someone can apply for you
A helper can fill out the forms with you. You sign the Part B form yourself. Your employer fills out and signs its part of form CMS-L564.
A helper can fill it out, but you still sign.
What happens after you apply
Ask the benefits office if your coverage comes from a current job. Ask how many workers the employer has.
YouA helper can help with this
At 65 or older, if the employer has 20 or more workers, the job plan pays first. With fewer workers, Medicare pays first. Then your job plan may not pay unless you have Part A and Part B.
YouA helper can help with this
COBRA and retiree coverage do not count as job coverage. They do not give you a later window to sign up. If you wait, a late fee can last for life.
If you have COBRA or retiree coverage
YouOnly you can do this
Once you can get free Part A, you lose help paying for your Covered California plan. If you keep getting that help, you may have to pay it back at tax time. End the plan when Medicare starts.
If you have Covered California
YouOnly you can do this
Ask your employer to fill out form CMS-L564. It shows you had job coverage.
When the job or the job coverage ends
YouA helper can help with this
Send form CMS-40B with the CMS-L564 to Social Security, or sign up online.
Social SecurityA helper can help with this Within 8 months after the job or the job coverage ends, whichever comes first.
Keep letters that say your drug coverage is as good as Medicare's. If you lose it, you have 2 full months to join Medicare drug coverage. Which plan is your choice. HICAP gives free, unbiased help.
YouA helper can help with this
Medicare and VA do not pay for the same care. You choose which to use each time. VA care does not give you a later window to sign up. TRICARE and CHAMPVA need both Part A and Part B to keep your coverage. TRICARE pays after Medicare unless you are on active duty.
If you have VA, TRICARE or CHAMPVA coverage
YouOnly you can do this
Part B starts the month after Social Security gets your forms. If you sign up while still covered, you can ask to start up to 3 months later.
Medicare
What only you can do
- Decide when to take Part B. It depends on the kind of coverage you have.
- Sign form CMS-40B yourself.
- Ask your employer to complete form CMS-L564.
- How long it takes
- Part B starts the month after Social Security gets your forms. While still covered, you can pick a start up to 3 months later.
- You are enrolled when
- You are enrolled when your Medicare card or letter shows Part B. Its start date should leave no gap in coverage.
- To keep it
- Keep proof of your job coverage and your drug coverage. You may need it later to avoid late fees.