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For anyone who worked past 65 with employer health coverage and is retiring now:

WARNING: Miss Your 8-Month Window and Medicare Adds a Penalty to Every Part B Bill for the Rest of Your Life

Here's the filled-in CMS-40B and CMS-L564 kit that gets you signed up on time, even if your old employer is slow, closed, or won't sign.

PART B · 2026 EDITIONLateEnrollmentKit
Filled CMS-40B and CMS-L564, step by step
Part B Forms
MONEY-BACKGUARANTEE14DAYS
Part B Late Enrollment Kit · 2026 Edition
  • Filled CMS-40B example
  • Filled CMS-L564 example for your employer
  • If your employer won't sign or is gone
  • + 3 free bonuses
$39one time · yours to keep
Yes! Send me the Late Enrollment KitInstant download · $39 one time

Secure checkout by Gumroad · Visa · Mastercard · Amex · PayPal

  • Secure checkout by Gumroad
  • Instant PDF download
  • Checked against SSA.gov & CMS.gov
  • 14-day money-back

Dear friend,

You did everything right. You kept working past 65. You kept your employer's health plan. You didn't need Part B yet.

Now you're retiring, and suddenly there are two government forms standing between you and your Medicare: Form CMS-40B, which you fill in, and Form CMS-L564, which your employer has to fill in and sign.

Then the trouble starts. HR has never seen an L564. Or they fill in Section B wrong. Or the company was sold and nobody knows who should sign.

Sound familiar?

Here's what's at stake. You have 8 months from the month your job or your employer coverage ends, whichever comes first. Miss it, and you may have to wait for the General Enrollment Period (January 1 to March 31), go months without Part B, and pay a late penalty.

And that penalty doesn't go away. It's 10% of the Part B premium for every full year you were late, for as long as you have Medicare.

What a missed deadline costs

Two full years late means 20% more on every Part B bill. In 2026 that's $40.58 extra a month, and it goes up every time the premium goes up. Over a 20-year retirement, that adds up to many thousands of dollars.

Most people who get caught didn't do anything careless. They just didn't know:

  • That the 8 months start when the job or the coverage ends, whichever is first.
  • That COBRA and retiree coverage don't count as coverage from current work.
  • What to send when the employer won't or can't sign the L564.
  • Exactly what Section B should say, so Social Security doesn't send it back.

That's why we made this kit.

Introducing the Part B Late Enrollment Kit

Filled-in examples of Forms CMS-40B and CMS-L564, plus a plan for when your old employer is slow, gone, or won't sign.

  • Filled CMS-40B exampleEvery field filled for someone who worked past 65, with notes on the boxes people get wrong.
  • Filled CMS-L564 example for your employerHand it to HR with Section B already explained, so they sign it right the first time.
  • If your employer won't sign or is goneThe other proof Social Security accepts: W-2s, pay stubs, insurance cards, and how to present them.
  • 8-month deadline worksheetFind your exact Special Enrollment Period end date, so you don't miss it by a week.
  • Ready-to-sign cover letterOne page that tells Social Security what you're sending and why you qualify.
  • How to submit: online, by fax, or by mailStep by step for each route, and how to confirm it arrived.

Here's a look inside

CMS-L564 · Section BEXAMPLE
Field 3: Is (or was) the applicant covered under your group health plan? · Date coverage began (mm/yyyy)
Yes · 04/1998
The month and year coverage based on current employment started.
Field 4: Has the coverage ended? · Date coverage ended (mm/yyyy)
Yes · 07/2026
This date starts your 8-month clock. HR often leaves it blank or writes COBRA dates instead. Ask for the date active-employee coverage ended.

Plus 3 free bonuses

Included with every copy, at no extra cost:

Free bonus #1

Letter to Your Employer's HR

A polite, ready-to-send letter that asks HR to complete Section B of the CMS-L564, with a date to reply by.

BONUS
Free bonus #2

Printable Document Checklist

Everything to gather before you apply, in the order Social Security asks for it.

BONUS
Free bonus #3

"If You Missed the 8 Months" Guide

What your options are if the window has already closed, and how to keep the penalty as small as possible.

BONUS

Choose your kit

Late Enrollment only
Part B Late Enrollment Kit
PART B · 2026 EDITIONLateEnrollmentKit
Filled CMS-40B and CMS-L564, step by step
Part B Forms
  • Filled CMS-40B example
  • Filled CMS-L564 example for your employer
  • 3 free bonuses
$39
Get this kit
Instant PDF download
Best value
Part B + IRMAA Bundle
  • Late Enrollment Kit
  • IRMAA Appeal Kit
  • All 6 bonuses
Bought separately: $88$69
You save $19
Get both kits
Instant PDF download
IRMAA only
IRMAA Appeal Kit
2026 EDITIONIRMAAAppeal Kit
Lower your Medicare surcharge with Form SSA-44
Part B Forms
  • SSA-44 walkthrough for all 8 life-changing events
  • Evidence checklist for your event
  • 3 free bonuses
$49
Get this kit
Instant PDF download
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Get your paperwork right, or get your money back. Guaranteed.

We know $39 is real money, and you may still be skeptical. That's fair. You've never heard of us, and Medicare paperwork is not something you want to gamble on.

So here is our promise. Download the Part B Late Enrollment Kit. Read it. Use it. If you don't feel it made your paperwork clearer and easier, email us within 14 days and we'll refund every cent through Gumroad.

No forms to fill in. No questions. No hard feelings. You take zero risk; we take all of it.

The Part B Forms team
Atomic Development

"The forms are free. Why pay $39?"

They are free, and we'll show you where to get them. You're not paying for the forms. You're paying for filled-in examples and a plan, so the forms are accepted the first time and your deadline doesn't slip away while you go back and forth.

Every full year of delay adds $20.29 a month to your Part B bill in 2026, for life. The kit costs $39, once.

"My HR department will handle it."

Maybe. But many HR departments see this form once every few years. The kit includes a ready-to-send letter that tells them exactly what to fill in, so you're not relying on them to figure it out.

This kit is for you if

  • You kept working past 65 with employer health coverage and are retiring now
  • You were told you need Forms CMS-40B and CMS-L564 and don't know where to start
  • Your HR department is slow, closed, or doesn't know the form

It's not for you if

  • You're signing up during your first Initial Enrollment Period (you don't need these forms)
  • Your only coverage after 65 was COBRA or retiree insurance (the kit explains your options)

Questions before you buy

Are the forms free?

Yes. CMS-40B and CMS-L564 are free from cms.gov, and you can apply online. The kit gives you filled examples and a plan so the free forms are accepted the first time.

Is this from Medicare?

No. Part B Forms is an independent guide. We are not affiliated with Medicare, CMS, or Social Security.

My employer went out of business. Can I still use this?

Yes. The kit covers the other proof Social Security accepts, such as W-2s, pay stubs and insurance cards, and how to send them.

What format is it?

A PDF you download right after checkout through Gumroad. Read it on screen or print it at home.

What if I don't find it useful?

Email us within 14 days of buying and we refund you in full through Gumroad.

Sign up for Part B late without a lifetime penalty

PART B · 2026 EDITIONLateEnrollmentKit
Filled CMS-40B and CMS-L564, step by step
Part B Forms
Yes! Send me the Late Enrollment KitInstant download · $39 one time

Secure checkout by Gumroad · Visa · Mastercard · Amex · PayPal

  • Secure checkout by Gumroad
  • Instant PDF download
  • Checked against SSA.gov & CMS.gov
  • 14-day money-back

P.S. Your 8-month window is already running. The sooner your forms are in, the less can go wrong.

P.P.S. You're covered by our 14-day money-back guarantee. If the kit doesn't make your paperwork clearer, email us for a full refund.

Part B Forms is an independent guide by Atomic Development, not affiliated with Medicare, CMS, or Social Security. The official forms are free from cms.gov and ssa.gov; the kit is help filling them in. Not legal or financial advice. Social Security makes every decision; no outcome is guaranteed.