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

   www.ssa.gov › medicare › sign-up

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   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).

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

   www.cms.gov › Medicare › CMS-Forms

   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).

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

   www.medicare.gov › basics › forms-publications-mailings

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   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. www.cms.gov › files › documentApplication for Enrollment in Medicare Part B (Medical Insurance)

   www.cms.gov › files › document

   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. faq.ssa.gov › en-us › TopicHow do I sign up for Medicare Part B if I already have Part A? -...

   faq.ssa.gov › en-us › Topic

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   If you qualify for an SEP, you can apply online at Apply for Medicare Part B Online during a Special Enrollment Period. You can also fax or mail your completed Application for Enrollment in Medicare – Part B (CMS-40B) and the Request for Employment Information (CMS-L564) enrollment forms and evidence of employment to your local Social ...

6. www.medicare.gov › sign-up › ready-to-sign-up-for-part-a-part-bReady to sign up for Part A & Part B - Medicare

   www.medicare.gov › sign-up › ready-to-sign-up-for-part-a-part-b

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   Apply online to sign up for Part B if you already have Part A. Have the employer fill out form CMS-L564. Send the completed form to your local Social Security office by fax or mail. If the employer can’t fill it out, complete Section B of the CMS-L564 form as best you can, but don’t sign it.

7. www.templateroller.com › group › 16197Form CMS-40B Application for Enrollment in Medicare Part B...

   www.templateroller.com › group › 16197

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   Download Fillable Form Cms-40b In Pdf - The Latest Version Applicable For 2024. Fill Out The Application For Enrollment In Medicare Part B (medical Insurance) Online And Print It Out For Free.