How to get help contesting a Social Security decision

Dear Toni: In response to last week’s question from Tonya, you advised her to contact her local congressional office to help appeal a Medicare issue.

I now must fight Social Security because they are under the impression that I have waited past my eight-month window to enroll in Medicare, which I did not.

I turned in my forms to the local Social Security office within the correct window, but that office lost my paperwork and will not accept what I have because they say it is past the enrollment window.

I am now receiving a Part B penalty. What a nightmare! Can you please explain what I should do to get help from my representative in Congress to appeal an inaccurate Medicare decision? — Evelyn, Conroe, Texas

Dear Evelyn: Because Medicare and Social Security are federal programs, your congressional office is the one to help you solve issues with Social Security, Medicare or other federal programs. Visit the website for your local representative to obtain contact information.

For people retiring past age 65, the Medicare special enrollment period begins the month they lose employer benefits or their employment ends.

Many enroll in Part B with a big surprise: finding they are penalized 10 percent each year hey could have had Part B but didn’t. The penalty goes all the way back to the day they turned 65 or the day their Part A began.

Below are a few of the Social Security forms used for Medicare (remember to write “special enrollment period” on top of these forms when submitting them):

■ CMS-L564, Request for Employer Benefits: This form shows proof of employer health benefits from a specific employer. If you have had two or more employers since turning 65, have a CMS-L564 form signed by each of them to turn into Social Security when applying for Medicare Part B.

■ CMS-40B, Application for Enrollment in Medicare Part B: This is the application for enrolling in Medicare Part B (medical insurance). Attach this form with CMS-L564 when applying for Part B after leaving employer benefits past age 65 and 90 days.

■ SSA-44, Medicare Income-Related Monthly Adjusted Amount — Life-Changing Event: This paperwork advises Social Security of a life-changing event and decrease in income. Such events include marriage, divorce, death of a spouse, stopping work or a reduction in hours, lost property, end of pension payments and more.

■ CMS-1763, Request for Termination of Premium Medicare Part A (hospital) or Part B (medical): This one is used to stop your Part A or Part B when needed.

Evelyn, you should pull together any documents and evidence you have to prove you did not wait past your eight-month window to apply for Medicare. Have them ready to show or send to your congressional representative.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.