How to Enroll in Medicare

When First Eligible – Initial Enrollment Period

  • Initial Enrollment Period is the 3 months before your 65th birthday, the month you turn 65, and 3 months after the month you turn 65.
  • Apply Online
    • There will be a question to allow you to decline Medicare Part B.
  • Apply in person at your local Social Security Office

When You Retire or Lose Benefit Eligibility (You are Already Medicare Eligible) - Special Enrollment Period

  • Apply two to three months prior to losing active employee coverage
  • Effective date of coverage will be the first of the month after your active employee coverage terminates
  • When does your active employee health coverage terminate?
  • Contact the PEBB Health Team in the Employee Benefits to request the SSA Request for Employment Information form. This form allows you to enroll and exempts you from the penalty for not enrolling when first eligible. You will need an SSA Request for Employment Information form for you and/or your spouse if Medicare eligible.
    • Phone: 541-737-2805
    • Fax: 541-737-0541
    • Email: [email protected]
      • IMPORTANT: If you scan and email the form, do NOT add your SSN and/or your spouse's SSN to the form.
  • Complete the Application for Medicare Part B (you are already enrolled in Medicare Part A)
  • Take the SSA Request for Employment Information form and Application for Medicare Part B to your local Social Security Office.
  • Request a Letter of Entitlement notice from the Social Security Office, this will be used to verify your enrollment in Medicare Part A & B to allow you to enroll in a Medicare Supplemental/Advantage plan.


State of Oregon Senior Health Insurance Benefits Assistance (SHIBA)
Provides assistance with Medicare & Medicare Supplemental Plans - Medicare Starts at Age 65
Phone: 800-722-4134 or 503-947-7979