Medicare Initial Enrollment Questionnaire

Medicare does not automatically know if you have any other health coverage, so about three months before you become eligible for Medicare, you will receive a letter in the mail informing you on how to complete the Medicare Initial Enrollment Questionnaire. It’s in your best interest to complete this form without delay.

There are two ways you can fill out the questionnaire:

  1. Create an online account at mymedicare.gov, a secure portal allowing you to also access claims and additional information.
  2. Phone Medicare’s Benefits Coordination & Recovery Center (BCRC) toll free at 855-798-2627.

The questions may vary depending on whether you qualify for Medicare because you’re turning 65 or if you’ve been receiving disability benefits for 24 months, or qualify because of kidney failure.

In any case, the form is designed to help determine if Medicare will be your primary or secondary coverage. For example, it asks if you or your spouse are currently working for an employer that offers health coverage, and if so if the employer has 20 or more employees (if you’re 65 or older). In this case, answering yes means your employer health plan will be primary and pay your medical bills first. If you answer no, Medicare will be primary and pay first. Checking the “don’t know” box means Medicare will contact your employer to find out. The “don’t know” option could delay enrollment, so let’s talk before you submit the form.

A reminder to contact me about 3-6 months before the month you turn 65 to review your situation and your options. If you would like assistance regarding the questionnaire, this would be a perfect time for us to talk.