Medicare Enrollment
How To Enroll in Medicare Part B if You Already Have Part A
Before You Apply for Medicare Part B
Since you did not enroll in Part B when you first got Part A, you’ll need to show proof that you had creditable health coverage starting from either your 65th birthday or your Part A effective date — whichever came first.
To do this, you’ll need the Request for Employment Information form.
Step 1: Send this form to your employer to complete.
📌 Important: If both you and your spouse are applying for Medicare, each of you must submit your own completed form.
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- The form must be filled out by the employer that provided the health insurance coverage
- See the section below for guidance on how to fill out this form correctly.
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Step 2: Once your employer returns the completed form, you’re ready to apply for Part B.
About the Request for Employment Information Form
This form is required to prove you’ve had creditable coverage and are eligible to enroll in Medicare Part B without incurring a late enrollment penalty.
Who Needs to Complete It?
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Take the form to your (or your spouse’s) Human Resources or Benefits Department for completion.
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A separate form is needed for each spouse applying for Medicare.
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The employer must be the one that provided the group health coverage — even if that’s not the current or shared employer.
What the Form Verifies
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The dates you (or your spouse) were actively employed.
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The start date of your group health plan coverage.
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🔍 Important: The coverage start date should reflect your original enrollment in employer-sponsored health insurance — not a later reenrollment date.
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Have You Changed Employers Since Turning 65?
If you’ve had group coverage from multiple employers since turning 65, you’ll need a separate completed form from each one.
Can’t Get the Form Signed?
If your former employer is out of business or can’t complete the form, don’t worry — other documents may be accepted as proof of coverage. Contact HTA for a list of acceptable alternatives.