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Get CMS-L564 S 2016-2024

FORMULARIO? ¿QUÉ HAGO CON EL FORMULARIO? Para solicitar Medicare en un Período de Inscripción Especial, debe tener o haber tenido cobertura del plan de salud grupal en los últimos 8 meses a través de su empleo actual o el de su cónyuge. Las personas con discapacidad deben tener la cobertura del plan de salud grupal grande sobre la base de su empleo actual o el de su cónyuge o de un miembro de la familia. Llene la Sección A y lleve el formulario a su empleador. Pídale a su empleador .

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