What Is a Cms L564 Form

This form is used for proof of group health care coverage based on current employment. This information is needed to process your Medicare enrollment application. The employer that provides the group health plan coverage completes the information about your health care coverage and dates of employment.

What is the purpose of CMS-L564?

Form CMS-L564 is a form used by the Social Security Administration to grant a Special Enrollment Period to Medicare beneficiaries who initially turned down Part B coverage because they were receiving group health benefits from their employer or a spouse’s employer.

How long does it take for a Medicare part B application to be approved?

It takes about 45 to 90 days to receive your acceptance letter after submitting your Medicare application.