Lost Your Job After 65 With No Health Insurance? Here’s What to Do

Losing a job at any age is stressful — but losing it after 65, when you may not have signed up for Medicare Part B or any other coverage yet, adds urgency. The good news is that federal rules give you real protections and enrollment windows. Here’s exactly what to do, in order, so you don’t end up with a coverage gap or a permanent late-enrollment penalty.

What should I do first if I lose my job and health insurance after 65?

Figure out which of these three situations applies to you, because your next step depends on it:

• You already have Medicare Part A but never enrolled in Part B (common if you were working and covered by an employer plan) — you likely qualify for a Medicare Special Enrollment Period.
• You don’t have Medicare at all yet because you never applied — you’ll need to apply for Medicare through Social Security.
• You’re not yet 65 but lost job-based coverage — you’re not eligible for Medicare yet, but you likely qualify for COBRA and/or a Marketplace Special Enrollment Period.

How do I apply for Medicare if I never enrolled?

You can apply with the Social Security Administration in three ways, per SSA.gov:

• Online at ssa.gov/benefits/medicare
• By phone at 1-800-772-1213 (TTY 1-800-325-0778), Monday–Friday, 8 a.m.–7 p.m.
• In person at your local Social Security office — use the Field Office Locator to find the one serving your NYC neighborhood

Applying online is usually the fastest option if you’re comfortable with a computer. You’ll need to create a personal my Social Security account first.

If I already have Part A, how do I add Part B after losing job coverage?

Because you had coverage through an employer, you likely qualify for the Part B Special Enrollment Period (SEP) — a rule that lets you sign up for Part B without the usual late-enrollment penalty. Per Medicare.gov, this SEP gives you 8 months from the date your job or your employer coverage ends (whichever happens first) to enroll in Part B penalty-free.

Important: this 8-month window is based on when your active employment or employer group coverage ends — not when any COBRA coverage you elect afterward runs out. COBRA does not extend this deadline.

To enroll, you (and your former employer) complete two forms:

• CMS-40B — your application for Part B. Download the form here.
• CMS-L564 — the “Request for Employment Information” form. You complete Section A; your former employer completes Section B, confirming your coverage dates. Download the form here.

You can submit both forms online through your Social Security online account, or fax/mail them to your local Social Security office. Keep copies of everything and follow up by phone to confirm receipt.

What if I’m not 65 yet and just lost my job?

You have two main paths for coverage until you turn 65 and become Medicare-eligible:

• COBRA continuation coverage: If your employer offered COBRA, per the U.S. Department of Labor, you can generally keep your same group plan for up to 18 months, though you’ll pay the full premium plus an administrative fee yourself.
• ACA Marketplace plan: Losing job-based coverage triggers a 60-day Special Enrollment Period to enroll in a Marketplace plan, per Healthcare.gov. Depending on your income, you may qualify for premium tax credits that make a Marketplace plan considerably cheaper than COBRA. New Yorkers can also shop through NY State of Health.

What You Should Do Now

• Confirm your exact coverage-end date with your former employer’s HR or benefits department in writing — this date starts your enrollment clocks.
• If you’re 65+, start your Part B or full Medicare application immediately — don’t wait to “see what happens” with your job, since the SEP clock doesn’t pause.
• If you’re under 65, compare COBRA against a Marketplace plan before defaulting to COBRA — a Marketplace plan with a subsidy is often significantly less expensive.
• Keep copies of every form you submit and follow up by phone with Social Security to confirm they were received and processed.
• Talk to a licensed advisor before choosing a plan — the right combination of Medicare Part B, a Medicare Advantage plan, a Medigap policy, or a Part D drug plan depends on your specific health needs and budget.

Frequently Asked Questions

Will I get a penalty if I wait too long to sign up for Part B?

Yes — if you miss your 8-month Special Enrollment Period, you could face a Part B late-enrollment penalty that permanently raises your monthly premium, and you may have to wait for the next General Enrollment Period to sign up at all. Enroll as soon as you know your job coverage has ended.

Can I get help paying my Part B premium if my income is limited?

Possibly. New York’s Medicare Savings Program (MSP) can help cover your Part B premium (and sometimes more) if you meet income and asset guidelines. Apply through your local Medicaid office or ask an advisor for help with the paperwork.

Does COBRA count as “creditable coverage” that avoids Medicare penalties?

No. COBRA is not considered coverage based on current employment, so it does not extend your 8-month Part B Special Enrollment Period. The clock starts when your active job or job-based coverage ends — not when COBRA runs out.