Toni Says

by Toni King

Help! Who do I contact with a serious Medicare enrollment issue?

 

Toni:

On November 6, when the government was still shut down, I turned in my Medicare enrollment forms signed by my employer to the local Social Security office. I never received anything from Social Security about being enrolled, so I went to the office and found out that my paperwork was lost. I refiled a copy of the forms with Social Security about 3 weeks ago and now my Social Security fun begins.

Now, I must fight Social Security because they are under the impression that I have waited past my 8-month window to enroll in Medicare Part B, which I did not. I am now receiving a Part B penalty. What a nightmare!

I remember reading a Toni Says Medicare article about asking a local Congressional office for help with Social Security or governmental issues. Can you please explain what one should do to get help from your congressperson in appealing an inaccurate decision about Medicare from a local Social Security office/agent? Thanks, Toni.
–Nick from San Antonio, Texas

Hello Nick:

If you need help with your Social Security and Medicare issues, then talk with your area’s congressional office. Your congressional office is the one to help you solve your issues with a federal rather than state government organization such as Social Security, Medicare, IRS, VA, or other federal programs. Visit your congressperson’s website for the local office contact information or you can email that office your issue from the Congressional website.

Page 17 of the 2026 Medicare & You Handbook under “Special Enrollment Period” explains the rules of leaving employer’s benefits when you are “still working” past 65. It discusses the special 8-month window for enrolling in Medicare and spells out that the 8-month period begins the month after the employment ends or health coverage ends, whichever happens first. Nick, when you enrolled with Social Security, you might have been close to the end of the 8-month window so let’s explain this to your congressional office’s agent when you contact them.

Below are a few of the Social Security forms used for Medicare: Don’t forget to write “Special Enrollment Period” to keep from receiving a penalty at the top of these specific forms (CMS-L546, CMS-40-B and SSA-44) , when turning the forms into the local Social Security office in your area or by email.

  • CMS-L564 – “Request for Employer Benefits” is the form that shows proof of employer health benefits from the specific employer. If you have had 2 or more employers since turning 65, have a CMS-L564 form signed by each employer to turn into Social Security when applying for Medicare Part B(medical insurance).
  •  CMS-40B – “Application for Enrollment in Medicare Part B” is the application for enrolling in Medicare Part B (medical insurance) Attach this form with the CMS-L564- (Request for Employer Benefits) when applying for Part B after leaving employer benefits past 65 and 90 days.
  • SSA-44- “Medicare Income-Related Monthly Adjusted Amount – Life-Changing Event” advises Social Security of a major life-changing event that has lowered your income. Life-changing events include marriage, divorce, the death of a spouse, work stoppage or reduced hours, lost, lost property, and more options listed on the SSA-44 form.

Nick, you should search for documents and evidence you have to prove that you did not wait past the 8-month window to apply for Medicare after leaving employer benefits. Have them ready to show or send to a representative from your congress person’s or local Social Security office.

Readers, remember to always have Part B in place when leaving your job or losing your company benefits. There might not be a second chance! Call the Toni Says® office at 832/519-8664 to schedule a Medicare review or email info@tonisays.com. Toni’s new course, a downloadable video series called the “Confused about Medicare Workshop” and the “Medicare Survival Guide Advanced” edition are available at www.tonisays.com. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.