The Rules of Transition: Working Past 65
If you are a senior in Vancouver, WA who has been happily working past 65, congratulations! You've likely been able to delay Medicare Part B and Part D without consequence. However, as the day of your retirement approaches, the rules change.
Medicare has very specific windows and requirements for seniors leaving employer group plans. Missing a step doesn't just mean a delay in coverage — it can mean life-long financial penalties and coverage gaps when you need care the most.
1The "20 Employee Rule"
If your employer has 20+ employees:
Your employer group health plan is "primary" and Medicare is "secondary." You can generally delay Part B without penalty as long as the coverage is considered "creditable."
If your employer has < 20 employees:
IMPORTANT: Medicare becomes "primary" the moment you turn 65. If you don't enroll, your small-group plan may pay nothing on your claims. You must enroll at 65!
The Magic Form: Form CMS-L564
This is the single most important document for working seniors in Clark County. When you apply for Part B outside of turning 65, Social Security requires proof that you didn't just forget to sign up — you had coverage.
Timothy's Pro-Tip on CMS-L564:
"Don't wait until your last day of work to ask HR for this. HR departments can be slow, and you need this form to file your Part B application. I recommend getting it into HR at least 60 days before you plan to retire."
The 90-Day Medicare Retirement Countdown
3 Months Before Retirement
Contact Social Security to confirm your eligibility and plan your Part B start date. If you already have Part A, you just need to add Part B.
2 Months Before Retirement
Request Form CMS-L564 from your HR department. This form must be signed by your employer to prove creditable coverage since age 65.
6-8 Weeks Before Retirement
Submit Form CMS-40B (Application for Part B) and the signed CMS-L564 to Social Security. Do not wait until your last day!
1 Month Before Retirement
Meet with an independent broker like Timothy Jones to compare Medicare Advantage and Medigap plans available in Clark County.
Day of Retirement
Celebrate! Your new Medicare coverage should be active on the 1st of the following month (or your retirement date if planned correctly).
⚠️Danger: The "COBRA Trap"
Many Vancouver enrollees think that if they choose COBRA after retiring, they can wait to enroll in Medicare until COBRA ends. THIS IS FALSE.Medicare does not consider COBRA to be "active employer coverage." If you wait for COBRA to end before enrolling in Part B, you will likely face a permanent late enrollment penalty and have a gap in coverage.
Don't Guess. Let Tim Guide Your Transition.
I specialize in helping seniors in Vancouver, WA and Clark County navigate the change from group health to Medicare. It costs you nothing to have an expert look over your timeline and ensure you're covered.