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  1. You must sign up for Part B using this form. NOTE: Your IEP lasts for 7 months. It begins 3 months before your 65th birthday (or 25th month of disability) and ends 3 months after you reach 65 (or 3 months after the 25th month of disability).

  2. Fill out the Application for Enrollment in Medicare Part B (CMS-40B) (PDF). If you are applying during the Special Enrollment Period, also fill out the Request for Employment Information (CMS-L564) (PDF).

  3. www.medicare.gov › basics › forms-publications-mailingsEnrollment Forms - Medicare

    Signing up for the Part B Immunosuppressive Drug benefit. Get the forms you need to sign up for Part B including CMS-40B, CMS-L564, CMS-10797, and CMS-10798.

  4. You must sign up for Part B using this form. If you’re in your IEP and refused Part B or did not sign up when you applied for Medicare, but now want Part B. If you want to sign up for Part B during the General Enrollment Period (GEP) from January 1 – March 31 each year.

  5. This package notifies people of the chance to enroll in Part B during the General Enrollment Period. It includes a letter and booklet. The package explains how to sign up for Part B, the risks for delaying enrollment, and other decisions you may need to make about your Medicare coverage.

  6. How to sign up for Part B. You have until March 31, 2024 to sign up for Part B. Your Part B coverage will start the first day of the month after you sign up. To sign up, fill out the enclosed form. Be sure to: Check the “YES” box and sign the application. Write in your Medicare Number that’s printed on your Medicare card.

  7. Sign up for Medicare. If you're 65 or older, you can enroll online for Parts A and B, or Part A only. You can delay Part B if you're already covered through an employer group health plan. The application is for retirement benefits and Medicare, or Medicare only. Apply online.

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