CMS-L564 — Request for Employment Information
Used to document employer group health coverage when applying for Medicare Part B through a Special Enrollment Period.
Official CMS-L564 Form & InstructionsResources
Medicare & Healthcare Resources Center
Resources for the Questions That Come Up Along the Way
Medicare questions don't stop after enrollment — and sometimes the help you need isn't about choosing a Medicare plan at all.
Clients frequently ask me where to find a particular Medicare form, how to report a suspicious call, where to obtain an Ohio Healthcare Power of Attorney or Living Will, or where to find reliable information about programs that may help with Medicare costs.
I've gathered many of the resources I most often share with clients and families here, so they're easy to find when you need them.
“Because being a resource for my clients means helping with more than a Medicare plan.”
Medicare forms & tools
Delayed Medicare Part B Because You Were Working?
CMS-40B — Request for Enrollment in Medicare Part B
Used to request enrollment in Medicare Part B. If you're enrolling through the Special Enrollment Period after employer coverage, the CMS-L564 is generally submitted with this form.
Official CMS-40B Form & InstructionsAdvance care planning — Ohio
Make Your Wishes Easier to Find.
For your convenience, the links below provide access to Ohio healthcare advance-directive resources. These documents are legal forms and are provided for informational purposes only. Please consult an attorney if you have questions about your individual legal needs.
Ohio Health Care Power of Attorney
This allows someone to designate a trusted person to make healthcare decisions if they become unable to make informed decisions themselves.
Ohio Health Care Power of Attorney – Ohio Legal HelpOhio Living Will
This documents a person's wishes regarding life-sustaining treatment if they are unable to communicate and are terminally ill or permanently unconscious.
Ohio Living Will – Ohio Legal HelpOhio Advance Directives — Complete Resource
LeadingAge Ohio provides Ohio advance-directive materials and educational guidance around both the Living Will and Health Care Power of Attorney. The Ohio State Bar Association also directs the public to LeadingAge Ohio for these forms.
Ohio Advance Directives – LeadingAge OhioProtect yourself
Protect Yourself
Knowing what to watch for can make an unexpected call or message easier to evaluate.
How to Spot a Medicare Scam
What Medicare will/won't ask for
Suspicious calls
How to report suspected Medicare fraud
Protecting your Medicare number
Please note: All resources on this page are provided for educational convenience and are not legal advice. Consult an attorney regarding your individual legal needs.
Financial assistance
Help With Medicare Costs.
These starting points can help you learn whether a program or reconsideration process may apply to your situation.
Extra Help / LIS
Information about help with Medicare prescription drug costs.
Medicare Savings Programs
A starting point for learning about programs that may help with Medicare premiums and other costs.
Medicaid resources
State and federal information about Medicaid eligibility and how it can work alongside Medicare.
IRMAA information and reconsideration resources
Learn how income-related Medicare adjustments work and where to find reconsideration information.
Lori's Medicare guides
A Few Helpful Guides to Keep Close.
Download a guide when you want a little more context before a conversation, appointment, or decision.
Preparing for Your Medicare Review?
Already have an appointment with Lori?
Complete or update your doctors, prescriptions, dosages and required pre-review information before your meeting.
Turning 65 Checklist
A practical timeline for preparing for Medicare eligibility and the decisions that come with it.
Employer Coverage vs. Medicare Comparison Worksheet
A worksheet for comparing employer coverage and Medicare while working beyond age 65.
DownloadWhat to Expect During Your Medicare Review
A practical guide to preparing for your Medicare Review and knowing what to bring.
Download
Medicare Enrollment Guide
A visual guide to the Initial Enrollment Period and the seven-month window around turning 65.
PDF available soon
Top 5 Medicare Mistakes and How to Avoid Them
Five common missteps to recognize before Medicare enrollment.
PDF available soon
How to Spot and Avoid Medicare Scam Calls
Practical guidance for recognizing and avoiding suspicious Medicare calls.
PDF available soon
Medicare Terminology
A quick reference for common Medicare enrollment, coverage, and financial terms.
A steady place to start