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  1. www.cms.gov › cms40b-application-enrollment-part-bCMS40B - Application for Enrollment in Part B | CMS

    This form is your application for Medicare Part B (Medical Insurance). You can use this form to sign up for Part B: During your Initial Enrollment Period (IEP) when you’re first eligible for Medicare; During the General Enrollment Period (GEP) from January 1 through March 31 of each year

  2. www.cms.gov › medicare › enrollment-renewalEnrollment Applications | CMS - Centers for Medicare & Medicaid...

    The following forms can be used for initial enrollment, revalidations, changes in status, and voluntary termination: CMS-855A (PDF) for Institutional Providers. CMS-855B (PDF) for Clinics, Group Practices, and Certain Other Suppliers.

  3. www.cms.gov › Medicare › CMS-FormsApplication for Enrollment in Medicare Part B (Medical Insurance)

    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).

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

    Request for Employment Information (CMS-L564) What’s it used for? Giving the Social Security Administration proof you’re eligible to sign up for Part B if: You’re still working. You retired within the last 8 months. You lost job-based health coverage within the last 8 months.

  5. www.cmsk12.org › enrollRegistration / Welcome - Charlotte-Mecklenburg Schools

    Enroll your Kindergarten student NOW! We are delighted to have you here to learn about the process of registering in Charlotte-Mecklenburg Schools. Whether you're a parent, guardian, or student, this website is your go-to resource for all things registration.

  6. edit.cms.gov › Medicare › CMS-FormsMEDICARE ENROLLMENT APPLICATION - Centers for Medicare & Medicaid...

    CMS may require you to submit or update your enrollment information. The MAC will notify you when it is time for you to revalidate your enrollment information. Do not submit a revalidation application until you have been contacted by your MAC. Previously enrolled in Medicare and you need to reactivate your Medicare billing number to resume billing.

  7. www.ssa.gov › medicare › sign-upSign up for Part B only | SSA

    If you have a special situation, fill out the Application for Medicare Part A and B — Special Enrollment Period (Exceptional Conditions) (CMS-10797) (PDF). Find your Social Security office and fax or mail us the completed form.

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