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The Medicare Initial Enrollment Questionnaire
What is the Initial Enrollment Questionnaire?
About three months before your entitlement to Medicare, you are mailed the Initial Enrollment Questionnaire (IEQ). The IEQ asks whether you have other insurance that pays before Medicare. To ensure correct payment of your Medicare claims, it is important to complete and return the IEQ timely. The questionnaire takes only 5 minutes to complete.
Si usted desea recibir el IEQ en espanol, por favor llame al COB Contractor al telefono 1-800-999-1118 or TTY/TDD 1-800-318-8782 (toll-free).
Follow this link to see a sample IEQ. This questionnaire is not available in a downloadable format.
Contact the Coordination of Benefits (COB) Contractor's Customer Service Department toll-free at 1-800-999-1118 or TTY/TDD: 1-800-318-8782 for the hearing and speech impaired with any questions you have. Representatives are available to assist you Monday through Friday, from 8:00 a.m. to 8:00 p.m., Eastern Time, except holidays.
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Beneficiaries' and Advocates' Frequently Asked Questions
