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Tips for Filling Out Your Medicare Initial Enrollment Questionnaire

Copyright © 2014 AARP. All rights reserved.

Medicare doesn’t automatically know what other health coverage (if any) you have. So about three months before you become eligible for Medicare, you receive through the mail a form called the Medicare Initial Enrollment Questionnaire. (The letter accompanying the form also tells you how to fill it out online or over the phone.)

Completing this questionnaire is very much in your interest. Your answers help Medicare make sure that payments for medical services you use are made promptly and accurately.

The actual form Medicare sends you varies according to the reason for your eligibility — for example, whether you qualify for Medicare coverage because you’re turning 65, have received disability benefits for 24 months, or have kidney failure (ESRD).

In each case, the form is designed to help determine whether Medicare will be your primary or secondary coverage. For example, it asks whether you or your spouse is currently working for an employer that provides health insurance — and if so, for the employer’s name and address.

It also asks whether the employer has 20 or more employees (if you’re 65 or older) or 100 or more employees (if you’re under 65 with disabilities). Answering “yes” to either of these questions means your employer health plan will pay your medical bills first. Answering “no” means Medicare will pay first.

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