Social Security Part B Enrollment Form

Please call us at 1 800 772 1213 tty 1 800 325 0778 monday through friday between 8 a m.

Social security part b enrollment form.

The form you are looking for is not available online. Or return forms by mail to your local social security office. If you don t already have part a you can apply online at ssa gov benefits medicare. If you worked for a railroad call the rrb at 1 877 772 5772.

Fill out a short form and send it to your local social security office. 1395o 1395s and 1395ii for your enrollment in medicare part b. Call social security at 1 800 772 1213. Or return the forms by mail to your local social security office.

If you have questions please contact social security at 1 800 772 1213 tty 1 800 325 0778. Fax them to 1 833 914 2016. When do i sign up. Please contact social security at 1 800 772 1213 tty 1 800 325.

To sign up please call our toll free number at 1 800 772 1213 tty 1 800 325 0778 you also may contact your local social security office. State i want part b coverage to begin mm yy in the remarks section of the cms 40b form or the online application. Visit your local social security office. If you live in puerto rico you will not receive medicare part b medical insurance automatically.

Visit faq ssa gov or call social security toll free at 1 800 772 1213 for more information. Visit faq ssa gov or call social security to free at 1 800 772 1213 tty 1 800 325 0778 for more information. Tty users can call 1 800 325 0778. Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c.

Many forms must be completed only by a social security representative. Social security is authorized to collect your information under sections 1836 1840 and 1872 of the social security act as amended 42 u s c. Signing up for part b is easy apply by march 31. Or contact your local social security office.

You can complete form cms 40b application for enrollment in medicare part b medical insurance and cms l564 request for employment information online. Get this form and instructions in spanish. Call social security at 1 800 772 1213 tty. Your employer doesn t need to sign section b of the cms l564 form.

1395o 1395s and 1395ii for your enrollment in medicare part b. If you already have part a and want to sign up for part b complete an application for enrollment in part b cms 40b. You can also fax the cms 40b and cms l564 to 1 833 914 2016. Social security and the centers for medicare medicaid services cms need your information to determine if you.

There s 3 ways you can sign up. You may complete the forms online by visiting the apply for medicare part b online during a special enrollment period webpage.